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General NPI Number Information
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NPI Number | 1073402376
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Entity Type | Individual
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Provider Name | THAO NGOC THANH DUONG
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Gender | Female
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 4801 S ALAMEDA ST
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City | CORPUS CHRISTI
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State | TX
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Zip | 78412-2332
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Country | US
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Telephone | 361-992-5729
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Fax |
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Provider Business Mailing Address
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Address Line | 19306 LUNA FALLS CT
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City | TOMBALL
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State | TX
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Zip | 77377-7859
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Country | US
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Telephone | 832-766-6783
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 73853
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License Number State | TX
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