Provider Demographics
NPI:1104154798
Name:RADWAN, NAGHAM R (PHARM D)
Entity type:Individual
Prefix:
First Name:NAGHAM
Middle Name:R
Last Name:RADWAN
Suffix:
Gender:F
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 1:6107 HIGH WAY 6 NORTH
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-1303
Mailing Address - Country:US
Mailing Address - Phone:281-856-8293
Mailing Address - Fax:281-856-7235
Practice Address - Street 1:6107 HIGH WAY 6 NORTH
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-1303
Practice Address - Country:US
Practice Address - Phone:281-856-8293
Practice Address - Fax:281-856-7235
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41068183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist