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General NPI Number Information
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NPI Number | 1205149622
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Entity Type | Individual
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Provider Name | TESFAY AINALEM RPH
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Gender | Male
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Dates
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Enumeration Date | 07/15/2010
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Last Update Date | 07/15/2010
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Provider Practice Location Address
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Address Line | 2015 THOMAS ST
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City | HOUSTON
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State | TX
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Zip | 77009-8044
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Country | US
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Telephone | 713-873-4127
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Fax |
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Provider Business Mailing Address
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Address Line | 12338 BRIGHTON LN
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City | STAFFORD
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State | TX
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Zip | 77477-1658
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Country | US
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Telephone | 281-564-1665
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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 | 32313
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License Number State | TX
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