Healthcare Provider Details

I. General information

NPI: 1306760871
Provider Name (Legal Business Name): VY THAO LY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2102 ELDRIDGE RD
SUGAR LAND TX
77478-1812
US

IV. Provider business mailing address

12565 ARC LN
STAFFORD TX
77477-6524
US

V. Phone/Fax

Practice location:
  • Phone: 281-242-2890
  • Fax:
Mailing address:
  • Phone: 281-410-6001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number77613
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: