MEDICARE: LEUL TESFAY RPH

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
1	183500000X	Pharmacist	336983	TX

General Provider Information

NPI Number	:	1720675200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEUL TESFAY RPH

Provider Business Mailing Address
First Line	:	4700 KIRBY DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-5004
Country	:	US
Telephone Number	:	713-533-2200
Fax Number	:	713-533-2206

Provider Business Practice Location Address
First Line	:	4700 KIRBY DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-5004
Country	:	US
Telephone Number	:	713-533-2200
Fax Number	:	713-533-2206

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2020
Last Update Date	:	12/30/2020

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Directions to “ LEUL TESFAY RPH” Practice Location

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