Provider Demographics
NPI:1194339341
Name:PHARMARA LABS LLC
Entity type:Organization
Organization Name:PHARMARA LABS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TABRAIZ
Authorized Official - Middle Name:M
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:908-797-2080
Mailing Address - Street 1:1511 JUSTIN RD STE 106A
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-2196
Mailing Address - Country:US
Mailing Address - Phone:469-946-6690
Mailing Address - Fax:469-946-6691
Practice Address - Street 1:1511 JUSTIN RD STE 106A
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75077-2196
Practice Address - Country:US
Practice Address - Phone:469-946-6690
Practice Address - Fax:469-946-6691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-04
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy