Provider Demographics
NPI:1154918852
Name:KHAYAT, SAMMY (PHARMD BCSCP)
Entity type:Individual
Prefix:
First Name:SAMMY
Middle Name:
Last Name:KHAYAT
Suffix:
Gender:M
Credentials:PHARMD BCSCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13303 W AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-5800
Mailing Address - Country:US
Mailing Address - Phone:346-874-8805
Mailing Address - Fax:832-939-8128
Practice Address - Street 1:13303 W AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5800
Practice Address - Country:US
Practice Address - Phone:832-939-8137
Practice Address - Fax:832-939-8128
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX57280183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty