Provider Demographics
NPI:1881667384
Name:AINSLIE, PHILIP P (RPH)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:P
Last Name:AINSLIE
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 1:3323 BRUCE BLVD
Mailing Address - Street 2:BOX 479
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-7874
Mailing Address - Country:US
Mailing Address - Phone:254-939-6420
Mailing Address - Fax:
Practice Address - Street 1:36000 DARNALL LOOP
Practice Address - Street 2:
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544-5095
Practice Address - Country:US
Practice Address - Phone:254-286-7335
Practice Address - Fax:254-288-8479
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX256991835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy