Healthcare Provider Details

I. General information

NPI: 1851946248
Provider Name (Legal Business Name): TZUKUAN YOUNG PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2019
Last Update Date: 08/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11999 DALLAS PKWY
FRISCO TX
75033-4272
US

IV. Provider business mailing address

11999 DALLAS PKWY
FRISCO TX
75033-4272
US

V. Phone/Fax

Practice location:
  • Phone: 214-872-1515
  • Fax: 214-872-1516
Mailing address:
  • Phone: 214-872-1515
  • Fax: 214-872-1516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number56740
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: