Provider Demographics
NPI:1174880991
Name:EL-LAHAM, AHMAD KHALILL (PHARMD)
Entity type:Individual
Prefix:MR
First Name:AHMAD
Middle Name:KHALILL
Last Name:EL-LAHAM
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 1:7225 9TH AVE APT 1223
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-2093
Mailing Address - Country:US
Mailing Address - Phone:713-397-9760
Mailing Address - Fax:
Practice Address - Street 1:3700 HIGHWAY 365
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-7709
Practice Address - Country:US
Practice Address - Phone:409-724-1914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50999183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist