Provider Demographics
NPI:1427651553
Name:REHAN, ANKUSH PAL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANKUSH
Middle Name:PAL
Last Name:REHAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13122 VISTA BROOK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77041-1875
Mailing Address - Country:US
Mailing Address - Phone:832-544-9198
Mailing Address - Fax:
Practice Address - Street 1:3100 HIGHWAY 365 STE 90
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-7796
Practice Address - Country:US
Practice Address - Phone:409-729-3379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62829183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist