Provider Demographics
NPI:1235969643
Name:DEWAN, NAFI M (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NAFI
Middle Name:M
Last Name:DEWAN
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 1:1221 WESTERN YARROW AVE
Mailing Address - Street 2:
Mailing Address - City:JUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:76247-2199
Mailing Address - Country:US
Mailing Address - Phone:469-231-8297
Mailing Address - Fax:
Practice Address - Street 1:1221 WESTERN YARROW AVE
Practice Address - Street 2:
Practice Address - City:JUSTIN
Practice Address - State:TX
Practice Address - Zip Code:76247-2199
Practice Address - Country:US
Practice Address - Phone:469-231-8297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT714971835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist