Provider Demographics
NPI:1861786899
Name:MEMON, SANA (PHARMD)
Entity type:Individual
Prefix:
First Name:SANA
Middle Name:
Last Name:MEMON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4510 GARTH RD
Mailing Address - Street 2:TARGET PHARMACY STORE NUMBER (T-0887)
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-2124
Mailing Address - Country:US
Mailing Address - Phone:281-422-5153
Mailing Address - Fax:281-422-5153
Practice Address - Street 1:4510 GARTH RD
Practice Address - Street 2:TARGET PHARMACY STORE NUMBER (T-0887)
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-2124
Practice Address - Country:US
Practice Address - Phone:281-422-5153
Practice Address - Fax:281-422-5153
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX46329183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist