Provider Demographics
NPI:1730891458
Name:ZENABEDEN, AHMAD OMAR (PHARMD)
Entity type:Individual
Prefix:
First Name:AHMAD OMAR
Middle Name:
Last Name:ZENABEDEN
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 1:4031 W PLANO PKWY
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5619
Mailing Address - Country:US
Mailing Address - Phone:972-369-8990
Mailing Address - Fax:877-396-1906
Practice Address - Street 1:4031 W PLANO PKWY
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5619
Practice Address - Country:US
Practice Address - Phone:972-369-8990
Practice Address - Fax:877-396-1906
Is Sole Proprietor?:No
Enumeration Date:2022-12-14
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64884183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1992414411OtherPHARMACY TAXONOMY