Provider Demographics
NPI:1992506752
Name:AINSLEY, EARLENE ANN (RPH)
Entity type:Individual
Prefix:MRS
First Name:EARLENE
Middle Name:ANN
Last Name:AINSLEY
Suffix:
Gender:
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2604 SAINT MICHAEL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-2378
Mailing Address - Country:US
Mailing Address - Phone:903-614-2200
Mailing Address - Fax:903-614-2868
Practice Address - Street 1:2604 SAINT MICHAEL DR STE 200
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-2378
Practice Address - Country:US
Practice Address - Phone:903-614-2200
Practice Address - Fax:903-614-2868
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24854183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist