Provider Demographics
NPI:1275900128
Name:SHAHIWALA, KIRAT (PHARMD, BSPHARM)
Entity type:Individual
Prefix:DR
First Name:KIRAT
Middle Name:
Last Name:SHAHIWALA
Suffix:
Gender:M
Credentials:PHARMD, BSPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12333 BEAR PLZ STE 100
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-0215
Mailing Address - Country:US
Mailing Address - Phone:817-789-4099
Mailing Address - Fax:800-616-4641
Practice Address - Street 1:12333 BEAR PLZ STE 100
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-0215
Practice Address - Country:US
Practice Address - Phone:817-789-4099
Practice Address - Fax:800-616-4641
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-26
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020404551835P0018X
TX603931835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist