Healthcare Provider Details

I. General information

NPI: 1013916873
Provider Name (Legal Business Name): CHEN-FUNG SOO IZFAR R.PH
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: NANCY IZFAR R.PH ( PHARMACIST )

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6630 DE MOSS DR
HOUSTON TX
77074-5004
US

IV. Provider business mailing address

10 TOKENEKE TRL
HOUSTON TX
77024-6727
US

V. Phone/Fax

Practice location:
  • Phone: 713-272-5578
  • Fax: 713-272-5550
Mailing address:
  • Phone: 713-467-2807
  • Fax: 713-467-2424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28955
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: