Provider Demographics
NPI:1487781803
Name:FALAKROU, FARNOUSH (PHARM, D)
Entity type:Individual
Prefix:DR
First Name:FARNOUSH
Middle Name:
Last Name:FALAKROU
Suffix:
Gender:F
Credentials:PHARM, D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9901 SAMAR RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87122-3351
Mailing Address - Country:US
Mailing Address - Phone:505-888-8542
Mailing Address - Fax:505-888-8541
Practice Address - Street 1:3901 CARLISLE BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-4503
Practice Address - Country:US
Practice Address - Phone:505-888-8542
Practice Address - Fax:505-888-8541
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM6412183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist