Provider Demographics
NPI:1982418968
Name:MOSTAFAVINAEINI, SEYEDBAUBAK (PHARMD)
Entity type:Individual
Prefix:
First Name:SEYEDBAUBAK
Middle Name:
Last Name:MOSTAFAVINAEINI
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:BOBBY
Other - Middle Name:
Other - Last Name:MOSTAFAVI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1920 E RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78741-1342
Mailing Address - Country:US
Mailing Address - Phone:512-326-5228
Mailing Address - Fax:
Practice Address - Street 1:1920 E RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78741-1342
Practice Address - Country:US
Practice Address - Phone:256-810-6580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-01
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75336183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist