Provider Demographics
NPI:1902639099
Name:AZARI, FARAMARZ (PHARMD)
Entity type:Individual
Prefix:
First Name:FARAMARZ
Middle Name:
Last Name:AZARI
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 1:14300 TANDEM BLVD APT 186
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78728-6614
Mailing Address - Country:US
Mailing Address - Phone:512-963-9745
Mailing Address - Fax:
Practice Address - Street 1:500 N BAGDAD RD
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-8791
Practice Address - Country:US
Practice Address - Phone:512-259-0130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74304183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist