Provider Demographics
NPI:1033929955
Name:MIR, KAZIM RAZA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KAZIM
Middle Name:RAZA
Last Name:MIR
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 1:1939 CHEYENNE RIVER CIR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-5405
Mailing Address - Country:US
Mailing Address - Phone:832-704-7548
Mailing Address - Fax:
Practice Address - Street 1:11112 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-4790
Practice Address - Country:US
Practice Address - Phone:713-458-2871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74759183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist