MEDICARE: BAOCHAU N VO PHARMD

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
1	183500000X	Pharmacist	IR 60247537	WA
2	183500000X	Pharmacist	E18417	ID

General Provider Information

NPI Number	:	1295092773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BAOCHAU N VO PHARMD

Provider Business Mailing Address
First Line	:	14203 JONES MALTSBERGER RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78247-3826
Country	:	US
Telephone Number	:	210-373-2489
Fax Number	:

Provider Business Practice Location Address
First Line	:	14203 JONES MALTSBERGER RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78247-3826
Country	:	US
Telephone Number	:	210-373-2489
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2012
Last Update Date	:	04/20/2012

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Directions to “ BAOCHAU N VO PHARMD” Practice Location

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