IndividualActive
Fantahun Yimam, PHARM.D.
NPI 1962534420 · Nutrition Support Pharmacist · Lubbock, TX
Provider details
- NPI number
- 1962534420
- Entity type
- Individual
- Primary specialty
- Nutrition Support PharmacistPharmacy Service Providers
- Credential
- PHARM.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 36401 (TX)
Specialties & taxonomies
Pharmacy Service Providers
Practice location
3615 19th St
Lubbock, TX 79410-1203
Phone: (806) 725-0419
Fax: (806) 725-0305
Approximate (ZIP-level) locationGet directions
Mailing address
4605 102nd St
Lubbock, TX 79424-7406
Registry dates
- Enumerated
- 2007-03-11
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.