Provider Demographics
NPI:1396345740
Name:AMAN, WOSEN REGA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:WOSEN
Middle Name:REGA
Last Name:AMAN
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 1:150 N BECKLEY ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-1844
Mailing Address - Country:US
Mailing Address - Phone:972-274-2426
Mailing Address - Fax:
Practice Address - Street 1:150 N BECKLEY ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-1844
Practice Address - Country:US
Practice Address - Phone:972-274-2426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302047318183500000X
TX49322183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist