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General NPI Number Information
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NPI Number | 1235481581
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Entity Type | Individual
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Provider Name | KWOKWAI SO RPH
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Gender | Male
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Dates
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Enumeration Date | 10/11/2012
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Last Update Date | 10/11/2012
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Provider Practice Location Address
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Address Line | 5005 N PIEDRAS STREET OUTPATIENT PHARMACY
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City | EL PASO
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State | TX
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Zip | 79920
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Country | US
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Telephone | 915-569-2632
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Fax |
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Provider Business Mailing Address
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Address Line | 4333 LOMA DE BRISAS DR
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City | EL PASO
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State | TX
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Zip | 79934-3702
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Country | US
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Telephone |
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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 | 25239
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH17698
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License Number State | MA
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