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Individual

ALAN GRIFFIN AINSWORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
1301 S MORGAN ST, GRANBURY, TX 76048-1987
(817) 279-9840
(817) 579-9731
Mailing address
13157 HWY 271, TYLER, TX 75708-2453
(903) 877-6823

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
27976
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1750865842
TAX ID NUMBER
TX
Enumeration date
12/23/2019
Last updated
12/23/2019
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