Provider Demographics
NPI:1215630538
Name:ARAI, KHALIL (PHARMD)
Entity type:Individual
Prefix:
First Name:KHALIL
Middle Name:
Last Name:ARAI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:KHALIL
Other - Middle Name:
Other - Last Name:AZHARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1301 PENNSYLVANIA AVE
Mailing Address - Street 2:PHARMACY DEPARTMENT (ATTENTION: KHALIL)
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-1301
Mailing Address - Country:US
Mailing Address - Phone:817-250-2096
Mailing Address - Fax:
Practice Address - Street 1:1301 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2122
Practice Address - Country:US
Practice Address - Phone:817-250-2096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51760183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist