Provider Demographics
NPI:1932709110
Name:ERMIAS, ABIY (PHARMD)
Entity Type:Individual
Prefix:
First Name:ABIY
Middle Name:
Last Name:ERMIAS
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 1:5302 N GARLAND AVE
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-2715
Mailing Address - Country:US
Mailing Address - Phone:972-495-2515
Mailing Address - Fax:
Practice Address - Street 1:5302 N GARLAND AVE
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-2715
Practice Address - Country:US
Practice Address - Phone:972-495-2515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX52339183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX52339OtherTEXAS STATE BOARD OF PHARMACY