Provider Demographics
NPI:1205149622
Name:AINALEM, TESFAY (RPH)
Entity type:Individual
Prefix:
First Name:TESFAY
Middle Name:
Last Name:AINALEM
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 1:12338 BRIGHTON LN
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-1658
Mailing Address - Country:US
Mailing Address - Phone:281-564-1665
Mailing Address - Fax:
Practice Address - Street 1:2015 THOMAS ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77009-8044
Practice Address - Country:US
Practice Address - Phone:713-873-4127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32313183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist