Provider Demographics
NPI:1992300115
Name:ALZGHARI, AMNA KHALED (PHARMD)
Entity type:Individual
Prefix:DR
First Name:AMNA
Middle Name:KHALED
Last Name:ALZGHARI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:AMNA
Other - Middle Name:KHALED
Other - Last Name:ALZGHARI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3701 COVE MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76123-2398
Mailing Address - Country:US
Mailing Address - Phone:817-526-1809
Mailing Address - Fax:
Practice Address - Street 1:700 W SEMINARY DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76115-1340
Practice Address - Country:US
Practice Address - Phone:817-926-2661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX59373183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist