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NPI Code Detail

MEDICARE: HOANG DUNG PHAN

MEDICARE: HOANG DUNG 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
1183500000XPharmacist67453TX

General Provider Information

NPI Number : 1790388361
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOANG DUNG PHAN
Provider Business Mailing Address
First Line : 2301 E WACO DR
Second Line :
City : WACO
State : TX
Zip : 76705-3207
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2301 E WACO DR
Second Line :
City : WACO
State : TX
Zip : 76705-3207
Country : US
Telephone Number : 254-799-5412
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2020
Last Update Date : 11/17/2020

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Directions to “ HOANG DUNG PHAN ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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