Provider Demographics
NPI:1982247052
Name:BADER, AHMED (RPH)
Entity Type:Individual
Prefix:MR
First Name:AHMED
Middle Name:
Last Name:BADER
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 1:833 MORNINGSIDE TRL
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-4368
Mailing Address - Country:US
Mailing Address - Phone:469-920-0414
Mailing Address - Fax:
Practice Address - Street 1:2105 W SPRING CREEK PKWY STE 325
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-4552
Practice Address - Country:US
Practice Address - Phone:972-532-1008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65917183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist