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General NPI Number Information
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NPI Number | 1073267555
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Entity Type | Individual
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Provider Name | DANIEL G KIDANE PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 02/04/2022
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Last Update Date | 02/04/2022
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Provider Practice Location Address
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Address Line | 3400 VIRGINIA PKWY
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City | MCKINNEY
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State | TX
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Zip | 75071-3405
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Country | US
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Telephone | 214-250-5006
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Fax |
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Provider Business Mailing Address
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Address Line | 10966 STAGS LEAP CT
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City | HENDERSON
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State | NV
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Zip | 89052-8738
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Country | US
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Telephone | 617-285-3106
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 45665
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License Number State | TX
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