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NPI Code Detail

MEDICARE: KIM LONG PHARMACY #2

MEDICARE: KIM LONG PHARMACY #2
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P1200XPharmacotherapy Pharmacist22587TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
122587OTHERTXPHARMACY SATE LICENSE #
24528571OTHERTXNBP #

General Provider Information

NPI Number : 1205958469
Entity Type Code : Organization
Provider Name (Legal Business Name) : KIM LONG PHARMACY #2
Provider Business Mailing Address
First Line : 7601 W SAM HOUSTON PKWY S # 900
Second Line :
City : HOUSTON
State : TX
Zip : 77072-5218
Country : US
Telephone Number : 713-777-1414
Fax Number : 281-271-8414
Provider Business Practice Location Address
First Line : 9630 CLAREWOOD DR STE A5
Second Line :
City : HOUSTON
State : TX
Zip : 77036-3535
Country : US
Telephone Number : 713-777-8202
Fax Number : 281-271-8414
Authorized Official
Title or Position : OWNER
Name : MS. KIM D NGUYEN
Credential :
Telephone Number : 713-777-8202
Provider Enumeration Date : 04/06/2007
Last Update Date : 03/07/2023

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Directions to “KIM LONG PHARMACY #2 ” Practice Location

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