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General NPI Number Information
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NPI Number | 1215712054
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Entity Type | Individual
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Provider Name | SAMSON ABEBE
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Gender | Male
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Dates
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Enumeration Date | 08/29/2023
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Last Update Date | 08/31/2023
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Provider Practice Location Address
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Address Line | 6301 ELDORADO PKWY
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City | MCKINNEY
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State | TX
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Zip | 75070-5627
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Country | US
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Telephone | 972-542-4356
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Fax |
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Provider Business Mailing Address
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Address Line | 2022 FOX GLEN DR
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City | ALLEN
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State | TX
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Zip | 75013-2914
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Country | US
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Telephone | 972-302-7423
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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 | 69166
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License Number State | TX
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