Provider Demographics
NPI:1699003541
Name:OSMAN, ISLAM
Entity type:Individual
Prefix:
First Name:ISLAM
Middle Name:
Last Name:OSMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 OAKMONT DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-1004
Mailing Address - Country:US
Mailing Address - Phone:512-238-0475
Mailing Address - Fax:512-255-2367
Practice Address - Street 1:2821 OAKMONT DR
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-1004
Practice Address - Country:US
Practice Address - Phone:512-238-0475
Practice Address - Fax:512-255-2367
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43003183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist