Healthcare Provider Details

I. General information

NPI: 1699245407
Provider Name (Legal Business Name): CHIA EN HO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2018
Last Update Date: 12/30/2022
Certification Date: 12/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9625 WHITE SETTLEMENT RD
FORT WORTH TX
76108-4406
US

IV. Provider business mailing address

3301 DENTON HWY
HALTOM CITY TX
76117-3200
US

V. Phone/Fax

Practice location:
  • Phone: 817-367-3469
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number62332
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: