Healthcare Provider Details

I. General information

NPI: 1437168820
Provider Name (Legal Business Name): THOMAS KENNETH HUSTON RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 HOLCOMBE BLVD INPATIENT PHARMACY DEPT VA MEDICAL CENTER
HOUSTON TX
77030-4211
US

IV. Provider business mailing address

9404 ZYLE RD
AUSTIN TX
78737-3427
US

V. Phone/Fax

Practice location:
  • Phone: 713-794-7174
  • Fax:
Mailing address:
  • Phone: 713-794-7174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number23081
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: