MEDICARE: MS. KIM HUYNH PHARM. D.

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	41919	TX

General Provider Information

NPI Number	:	1689978363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KIM HUYNH PHARM. D.

Provider Business Mailing Address
First Line	:	5923 SANDIA LAKE LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77041-6160
Country	:	US
Telephone Number	:	713-443-9958
Fax Number	:

Provider Business Practice Location Address
First Line	:	14531 WESTHEIMER RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-5245
Country	:	US
Telephone Number	:	832-379-0541
Fax Number	:	832-379-0545

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

Provider Enumeration Date	:	01/10/2011
Last Update Date	:	01/10/2011

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