Provider Demographics
NPI:1144824228
Name:ALKHATEEB, SAMEER (SAM ALKHATEEB)
Entity type:Individual
Prefix:
First Name:SAMEER
Middle Name:
Last Name:ALKHATEEB
Suffix:
Gender:M
Credentials:SAM ALKHATEEB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4610 FRANKFORD RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-7107
Mailing Address - Country:US
Mailing Address - Phone:972-732-6197
Mailing Address - Fax:
Practice Address - Street 1:4610 FRANKFORD RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-7107
Practice Address - Country:US
Practice Address - Phone:972-732-6197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX476981835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist