Healthcare Provider Details

I. General information

NPI: 1265836381
Provider Name (Legal Business Name): SHERMAN KUAN PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2014
Last Update Date: 10/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1223 S MAIN ST
BOERNE TX
78006-2813
US

IV. Provider business mailing address

1223 S MAIN ST
BOERNE TX
78006-2813
US

V. Phone/Fax

Practice location:
  • Phone: 830-249-9565
  • Fax:
Mailing address:
  • Phone: 830-249-9565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number55239
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: