Provider Demographics
NPI:1720680465
Name:BARRIE, MOHAMED BEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:BEN
Last Name:BARRIE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6205 TUCKERS PL
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75089-7121
Mailing Address - Country:US
Mailing Address - Phone:832-488-0569
Mailing Address - Fax:
Practice Address - Street 1:2207 S BRIDGE ST
Practice Address - Street 2:
Practice Address - City:BRADY
Practice Address - State:TX
Practice Address - Zip Code:76825-7550
Practice Address - Country:US
Practice Address - Phone:325-597-3456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX56093183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist