Healthcare Provider Details

I. General information

NPI: 1891094645
Provider Name (Legal Business Name): MONICA HAN-YAN LUI CHI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2011
Last Update Date: 02/01/2020
Certification Date: 02/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17194 PRESTON RD STE 200
DALLAS TX
75248-1225
US

IV. Provider business mailing address

17194 PRESTON RD STE 200
DALLAS TX
75248-1225
US

V. Phone/Fax

Practice location:
  • Phone: 972-931-9371
  • Fax: 972-931-6891
Mailing address:
  • Phone: 972-931-9371
  • Fax: 972-931-6891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number16946
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number40728
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: