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NPI Code Detail

MEDICARE: BERHANE A DEMOZ

MEDICARE: BERHANE A DEMOZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist39953TX

General Provider Information

NPI Number : 1588991491
Entity Type Code : Individual
Provider Name (Legal Business Name) : BERHANE A DEMOZ
Provider Business Mailing Address
First Line : 1513 FLINTWOOD DR
Second Line :
City : RICHARDSON
State : TX
Zip : 75081-5331
Country : US
Telephone Number : 214-542-6598
Fax Number :
Provider Business Practice Location Address
First Line : 5742 E MOCKINGBIRD LN
Second Line :
City : DALLAS
State : TX
Zip : 75206-5422
Country : US
Telephone Number : 214-826-7136
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2009
Last Update Date : 01/11/2023

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Directions to “ BERHANE A DEMOZ ” Practice Location

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