Provider Demographics
NPI:1851646145
Name:MAHBUBANI, JAISHREE RAMESH (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JAISHREE
Middle Name:RAMESH
Last Name:MAHBUBANI
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5757 FAIRMONT PKWY
Mailing Address - Street 2:T-1396
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-3905
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5757 FAIRMONT PKWY
Practice Address - Street 2:T-1396
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-3905
Practice Address - Country:US
Practice Address - Phone:281-504-0144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51619183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist