Provider Demographics
NPI:1285246736
Name:KOLASO, YONAS CHURUKO (PHARMD)
Entity type:Individual
Prefix:DR
First Name:YONAS
Middle Name:CHURUKO
Last Name:KOLASO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 E OVILLA RD
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154-2445
Mailing Address - Country:US
Mailing Address - Phone:972-576-3303
Mailing Address - Fax:
Practice Address - Street 1:107 E OVILLA RD
Practice Address - Street 2:
Practice Address - City:RED OAK
Practice Address - State:TX
Practice Address - Zip Code:75154-2445
Practice Address - Country:US
Practice Address - Phone:972-576-3303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60090183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist