Healthcare Provider Details

I. General information

NPI: 1013740349
Provider Name (Legal Business Name): HIEP TRINH PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2024
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 WALLACE BLVD
AMARILLO TX
79106-1789
US

IV. Provider business mailing address

9200 TOWN SQUARE BLVD APT 3317
AMARILLO TX
79119-1314
US

V. Phone/Fax

Practice location:
  • Phone: 806-212-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number74540
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: