Provider Demographics
NPI:1972391936
Name:ABDUL BASIR, HIMAD
Entity type:Individual
Prefix:
First Name:HIMAD
Middle Name:
Last Name:ABDUL BASIR
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 HAWKFLY RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-4492
Mailing Address - Country:US
Mailing Address - Phone:402-975-5181
Mailing Address - Fax:
Practice Address - Street 1:6100 ARLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2901
Practice Address - Country:US
Practice Address - Phone:703-237-8118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202222688183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist