Provider Demographics
NPI:1427766450
Name:KHAN, SUBUL YAR (PHARMD)
Entity type:Individual
Prefix:
First Name:SUBUL
Middle Name:YAR
Last Name:KHAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1137 SPENCER ST
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-3365
Mailing Address - Country:US
Mailing Address - Phone:972-602-5163
Mailing Address - Fax:
Practice Address - Street 1:1540 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-4486
Practice Address - Country:US
Practice Address - Phone:214-383-9765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71634183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist