Provider Demographics
NPI:1720692510
Name:SADEK, ROSHDY ALY ROSHDY
Entity Type:Individual
Prefix:
First Name:ROSHDY
Middle Name:ALY ROSHDY
Last Name:SADEK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3614 CARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-2868
Mailing Address - Country:US
Mailing Address - Phone:862-571-1116
Mailing Address - Fax:
Practice Address - Street 1:3400 N BELT LINE RD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-7801
Practice Address - Country:US
Practice Address - Phone:972-594-1648
Practice Address - Fax:972-659-0494
Is Sole Proprietor?:No
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60685183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist