Provider Demographics
NPI:1538764485
Name:AMAYU, ISRAEL (PHRM D)
Entity type:Individual
Prefix:
First Name:ISRAEL
Middle Name:
Last Name:AMAYU
Suffix:
Gender:M
Credentials:PHRM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 W SPRING VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-4037
Mailing Address - Country:US
Mailing Address - Phone:972-997-9088
Mailing Address - Fax:972-997-9054
Practice Address - Street 1:325 W SPRING VALLEY RD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-4037
Practice Address - Country:US
Practice Address - Phone:972-997-9088
Practice Address - Fax:972-997-9054
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX540221835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist