MEDICARE: TUAN MINH TA PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	42871	TX

General Provider Information

NPI Number	:	1528397213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TUAN MINH TA PHARMD

Provider Business Mailing Address
First Line	:	950 STUDEMONT ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-5923
Country	:	US
Telephone Number	:	713-863-7663
Fax Number	:	713-863-8005

Provider Business Practice Location Address
First Line	:	950 STUDEMONT ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-5923
Country	:	US
Telephone Number	:	713-863-7663
Fax Number	:	713-863-8005

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2009
Last Update Date	:	12/09/2009

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