Provider Demographics
NPI:1326185521
Name:AYIKA, PETER V (RPH)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:V
Last Name:AYIKA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12974
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79913-0974
Mailing Address - Country:US
Mailing Address - Phone:915-760-6900
Mailing Address - Fax:915-760-6911
Practice Address - Street 1:7430 REMCON CIR
Practice Address - Street 2:STE A-2
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-3514
Practice Address - Country:US
Practice Address - Phone:915-760-6900
Practice Address - Fax:915-760-6911
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22185183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1417054412Medicare UPIN