Individual
AZADEH BAVAFA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
5184 TEX OAK AVE, DALLAS, TX 75235-7822
(214) 590-8000
Mailing address
6527 LAUREL VALLEY RD, DALLAS, TX 75248-3921
(214) 551-7376
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
62060
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
DO NOT HAVE ONE
—
Enumeration date
09/30/2022
Last updated
09/30/2022
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