Individual
DR. JEFFREY DAVID FAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
233 S MANSE AVE, GIDDINGS, TX 78942-3440
(979) 542-3164
(979) 542-3489
Mailing address
233 S MANSE AVE, GIDDINGS, TX 78942-3440
(979) 540-8926
(979) 542-3489
Taxonomy
Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
30228
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
264756
LICENSE TX 30228
TX
Enumeration date
12/10/2020
Last updated
12/10/2020
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