Provider Demographics
NPI:1770123408
Name:ALHUMAIDI, FAUZI ATEEQ (PHARM D)
Entity type:Individual
Prefix:DR
First Name:FAUZI
Middle Name:ATEEQ
Last Name:ALHUMAIDI
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 SHILOH RD STE 170
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-8258
Mailing Address - Country:US
Mailing Address - Phone:469-661-9007
Mailing Address - Fax:
Practice Address - Street 1:1409 SHILOH RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-4332
Practice Address - Country:US
Practice Address - Phone:469-661-9007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-10
Last Update Date:2022-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66579183500000X
MI5302412192183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5302412192OtherPHARMACY LICENSE NUMBER