Provider Demographics
NPI:1942806039
Name:CHARMCHI, YASSAMAN (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:YASSAMAN
Middle Name:
Last Name:CHARMCHI
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5627 TIMBER BAY CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-5670
Mailing Address - Country:US
Mailing Address - Phone:346-218-1938
Mailing Address - Fax:
Practice Address - Street 1:608 SPRING HILL DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-6032
Practice Address - Country:US
Practice Address - Phone:281-466-5804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-05
Last Update Date:2020-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS12391183500000X
TX43181183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist