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General NPI Number Information
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NPI Number | 1902146814
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Entity Type | Individual
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Provider Name | KOK HONG TAN R.PH.
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Gender | Male
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Dates
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Enumeration Date | 03/01/2013
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Last Update Date | 03/01/2013
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Provider Practice Location Address
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Address Line | 4616 PINE BROOK DR
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City | PLANO
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State | TX
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Zip | 75024-3960
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Country | US
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Telephone | 214-298-5928
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Fax |
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Provider Business Mailing Address
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Address Line | 4616 PINE BROOK DR
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City | PLANO
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State | TX
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Zip | 75024-3960
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Country | US
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Telephone | 214-298-5928
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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 | 42298
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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 | S012043
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 15286
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License Number State | CO
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