Provider Demographics
NPI:1841802618
Name:VAZIRNEZAMI, RANA
Entity Type:Individual
Prefix:
First Name:RANA
Middle Name:
Last Name:VAZIRNEZAMI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6624 FANNIN ST STE 120
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2313
Mailing Address - Country:US
Mailing Address - Phone:713-795-0199
Mailing Address - Fax:
Practice Address - Street 1:6624 FANNIN ST STE 120
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2313
Practice Address - Country:US
Practice Address - Phone:713-795-0199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63412183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist