Healthcare Provider Details

I. General information

NPI: 1073405015
Provider Name (Legal Business Name): BEREKET GETAHUN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2025
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12400 DALLAS PKWY
FRISCO TX
75033-4224
US

IV. Provider business mailing address

2305 PLAZA BLVD APT 1330
RICHARDSON TX
75082-4041
US

V. Phone/Fax

Practice location:
  • Phone: 469-495-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number61385
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: