Provider Demographics
NPI:1669975561
Name:KHDAIR, AYMAN (RPH)
Entity type:Individual
Prefix:
First Name:AYMAN
Middle Name:
Last Name:KHDAIR
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5556 NEW TERRITORY BLVD APT 11107B
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-6557
Mailing Address - Country:US
Mailing Address - Phone:346-225-7473
Mailing Address - Fax:
Practice Address - Street 1:5556 NEW TERRITORY BLVD APT 11107B
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-6557
Practice Address - Country:US
Practice Address - Phone:346-225-7473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-16
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62246183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist