Provider Demographics
NPI:1922601145
Name:MOMIN, NAUREEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:NAUREEN
Middle Name:
Last Name:MOMIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 SIOUX ST
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-3313
Mailing Address - Country:US
Mailing Address - Phone:832-366-3145
Mailing Address - Fax:
Practice Address - Street 1:8277 BELLEVIEW DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-0358
Practice Address - Country:US
Practice Address - Phone:214-291-5087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX55681183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist