Provider Demographics
NPI:1922725787
Name:IJAZ, SADIA KALIM (RPH)
Entity Type:Individual
Prefix:
First Name:SADIA
Middle Name:KALIM
Last Name:IJAZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9884 HIGHWAY 242
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77385-4366
Mailing Address - Country:US
Mailing Address - Phone:936-273-5444
Mailing Address - Fax:832-647-1331
Practice Address - Street 1:9884 HIGHWAY 242
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77385-4366
Practice Address - Country:US
Practice Address - Phone:936-273-5444
Practice Address - Fax:832-647-1331
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37673183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist