Provider Demographics
NPI:1982206074
Name:MIKHAIL, EMAD (RPH)
Entity Type:Individual
Prefix:DR
First Name:EMAD
Middle Name:
Last Name:MIKHAIL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3165 JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-5613
Mailing Address - Country:US
Mailing Address - Phone:817-343-8340
Mailing Address - Fax:
Practice Address - Street 1:3165 JOHNSON RD
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-5613
Practice Address - Country:US
Practice Address - Phone:817-343-8340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX366521835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist