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NPI Code Detail

MEDICARE: ANDY PHAN

MEDICARE: ANDY PHAN
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
1183500000XPharmacist60064TX

General Provider Information

NPI Number : 1720529662
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDY PHAN
Provider Business Mailing Address
First Line : 5161 FRANZ RD
Second Line :
City : KATY
State : TX
Zip : 77493-1754
Country : US
Telephone Number : 281-391-3410
Fax Number : 281-391-3412
Provider Business Practice Location Address
First Line : 5161 FRANZ RD
Second Line :
City : KATY
State : TX
Zip : 77493-1754
Country : US
Telephone Number : 281-391-3410
Fax Number : 281-391-3412
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2017
Last Update Date : 01/03/2023

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Directions to “ ANDY PHAN ” Practice Location

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