Healthcare Provider Details

I. General information

NPI: 1174338974
Provider Name (Legal Business Name): JIA HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2025
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 FANNIN ST
HOUSTON TX
77030-2703
US

IV. Provider business mailing address

6711 HAWSLEY WAY
SUGAR LAND TX
77479-5799
US

V. Phone/Fax

Practice location:
  • Phone: 713-790-3311
  • Fax:
Mailing address:
  • Phone: 919-357-0742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number53081
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: