Provider Demographics
NPI:1679449003
Name:WAZIR, KIRAN
Entity type:Individual
Prefix:
First Name:KIRAN
Middle Name:
Last Name:WAZIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10802 PIONEER REST LN
Mailing Address - Street 2:
Mailing Address - City:ROSHARON
Mailing Address - State:TX
Mailing Address - Zip Code:77583-4693
Mailing Address - Country:US
Mailing Address - Phone:407-360-3032
Mailing Address - Fax:
Practice Address - Street 1:3045 SILVERLAKE VILLAGE DR
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-8080
Practice Address - Country:US
Practice Address - Phone:713-436-4892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-13
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76415183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist