Individual
DR. JEFFREY DAVID FAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
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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