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NPI Code Detail

MEDICARE: VAN-ANH PHAN

MEDICARE: VAN-ANH PHAN
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
1183500000XPharmacist37465TX

General Provider Information

NPI Number : 1306150321
Entity Type Code : Individual
Provider Name (Legal Business Name) : VAN-ANH PHAN
Provider Business Mailing Address
First Line : 3663 BRIARPARK DR
Second Line :
City : HOUSTON
State : TX
Zip : 77042-5205
Country : US
Telephone Number : 713-268-3630
Fax Number : 623-869-1717
Provider Business Practice Location Address
First Line : 11920 PRESTON RD
Second Line :
City : DALLAS
State : TX
Zip : 75230-2711
Country : US
Telephone Number : 972-980-4915
Fax Number : 972-382-1506
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2010
Last Update Date : 08/02/2010

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Directions to “ VAN-ANH PHAN ” Practice Location

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