Provider Demographics
NPI:1932438363
Name:NEMATZADEH, SHAHRZAD DARVISHI (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SHAHRZAD
Middle Name:DARVISHI
Last Name:NEMATZADEH
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 1:8104 MESA DR.
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759
Mailing Address - Country:US
Mailing Address - Phone:512-346-9598
Mailing Address - Fax:512-346-9255
Practice Address - Street 1:8104 MESA DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8615
Practice Address - Country:US
Practice Address - Phone:512-346-9598
Practice Address - Fax:512-346-9255
Is Sole Proprietor?:No
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42619183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist