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General NPI Number Information
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NPI Number | 1205958469
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Entity Type | Organization
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Legal Business Name | KIM LONG PHARMACY #2
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 9630 CLAREWOOD DR STE A5
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City | HOUSTON
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State | TX
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Zip | 77036-3535
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Country | US
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Telephone | 713-777-8202
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Fax | 281-271-8414
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Provider Business Mailing Address
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Address Line | 7601 W SAM HOUSTON PKWY S # 900
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City | HOUSTON
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State | TX
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Zip | 77072-5218
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Country | US
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Telephone | 713-777-1414
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Fax | 281-271-8414
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Authorized Official
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Title or Position | OWNER
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Name | MS. KIM D NGUYEN
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Credential |
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Telephone | 713-777-8202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 22587
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License Number State | TX
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