Provider Demographics
NPI:1700249653
Name:AHARANWA, AUGUSTA I (PHARMD)
Entity Type:Individual
Prefix:
First Name:AUGUSTA
Middle Name:I
Last Name:AHARANWA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-1008
Mailing Address - Country:US
Mailing Address - Phone:817-996-1092
Mailing Address - Fax:817-538-9147
Practice Address - Street 1:611 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010-1008
Practice Address - Country:US
Practice Address - Phone:817-996-1092
Practice Address - Fax:817-538-9147
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-29
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39480183500000X, 1835P0018X, 1835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care