Provider Demographics
NPI:1922608371
Name:JAAFAR, KHALIL WAFIC (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:KHALIL
Middle Name:WAFIC
Last Name:JAAFAR
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24418 GALO CYN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-1552
Mailing Address - Country:US
Mailing Address - Phone:210-900-8719
Mailing Address - Fax:210-545-4691
Practice Address - Street 1:1515 N LOOP 1604 E
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1431
Practice Address - Country:US
Practice Address - Phone:210-491-9001
Practice Address - Fax:210-545-4691
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS27256183500000X
MAPH20465183500000X
TX45055183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist