Healthcare Provider Details

I. General information

NPI: 1841357167
Provider Name (Legal Business Name): SAIGON HOUSTON PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 08/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8388 W SAM HOUSTON PKWY S STE 186
HOUSTON TX
77072-5079
US

IV. Provider business mailing address

8388 W SAM HOUSTON PKWY S STE 186
HOUSTON TX
77072-5079
US

V. Phone/Fax

Practice location:
  • Phone: 281-564-5400
  • Fax: 281-564-5404
Mailing address:
  • Phone: 281-564-5400
  • Fax: 281-564-5404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number25364
License Number StateTX

VIII. Authorized Official

Name: KIMBERLY TRUONG
Title or Position: OWNER AND PIC
Credential:
Phone: 832-451-7296