Provider Demographics
NPI:1972804540
Name:PERVEZ ARTHUR, NILOFER N (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:NILOFER
Middle Name:N
Last Name:PERVEZ ARTHUR
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:NILOFER
Other - Middle Name:
Other - Last Name:PERVEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:150 RUSTLEAF DR
Mailing Address - Street 2:APT # 20 B
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78242-1215
Mailing Address - Country:US
Mailing Address - Phone:509-301-5544
Mailing Address - Fax:
Practice Address - Street 1:2200 BERGQUIST DR STE 1
Practice Address - Street 2:LACKLAND AIR FORCE BASE
Practice Address - City:LACKLAND A F B
Practice Address - State:TX
Practice Address - Zip Code:78236-9908
Practice Address - Country:US
Practice Address - Phone:210-292-7216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-12
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034882183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
05211951OtherBIRTHDATE