Naser Abdallah
Individual provider Active NPI Pharmacist · Mansfield, TX
NPI 1770967903 · NPPES record last updated Jul 17, 2015
Key facts
- NPI
- 1770967903
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 56288 (TX)
- Practice address
- 700 Walnut Bend Dr
Mansfield, TX 76063-5857 - Phone
- (914) 355-6619
- NPI assigned
- Jul 17, 2015
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56288 | TX | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 56288 | TX | Yes |
Addresses
Primary practice location
700 Walnut Bend Dr
Mansfield, TX 76063-5857
Mailing address
700 Walnut Bend Drive
Mansfield, TX 76063
Phone (914) 355-6619
Other providers in Mansfield, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.