Provider Demographics
NPI:1902378011
Name:ROHAILREZA INC
Entity Type:Organization
Organization Name:ROHAILREZA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MALIK
Authorized Official - Middle Name:
Authorized Official - Last Name:MOTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-860-2834
Mailing Address - Street 1:58 PALO DURO CYN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-7337
Mailing Address - Country:US
Mailing Address - Phone:210-860-2834
Mailing Address - Fax:830-387-4759
Practice Address - Street 1:254 S HIGHWAY 123 BYP
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-5155
Practice Address - Country:US
Practice Address - Phone:210-860-2834
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROHAILREZA INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-31
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy