Provider Demographics
NPI:1205382009
Name:YANFUL, PAA KWESI (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PAA KWESI
Middle Name:
Last Name:YANFUL
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 1:122 W COLORADO BLVD FL 3
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-2382
Mailing Address - Country:US
Mailing Address - Phone:214-947-6780
Mailing Address - Fax:
Practice Address - Street 1:122 W COLORADO BLVD FL 3
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-2382
Practice Address - Country:US
Practice Address - Phone:214-947-6727
Practice Address - Fax:214-947-6744
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.0217121835P2201X
TX634341835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care