Provider Demographics
NPI:1659049666
Name:BEYENE, AKLILU AINALEM (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AKLILU
Middle Name:AINALEM
Last Name:BEYENE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 BROMPTON ST APT 5213
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-2169
Mailing Address - Country:US
Mailing Address - Phone:952-465-1879
Mailing Address - Fax:
Practice Address - Street 1:2214 N 1ST ST
Practice Address - Street 2:
Practice Address - City:CARRIZO SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78834-2036
Practice Address - Country:US
Practice Address - Phone:830-876-3506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-03
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68305183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist