MEDICARE: MRS. KAREN HYECHIN PARK R.PH.

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	35166	TX

General Provider Information

NPI Number	:	1407168693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KAREN HYECHIN PARK R.PH.

Provider Business Mailing Address
First Line	:	4001 PRESTON AVE STE 120
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77505-2051
Country	:	US
Telephone Number	:	281-998-2100
Fax Number	:	281-998-2101

Provider Business Practice Location Address
First Line	:	4001 PRESTON AVE STE 120
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77505-2051
Country	:	US
Telephone Number	:	281-998-2100
Fax Number	:	281-998-2101

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

Provider Enumeration Date	:	07/05/2010
Last Update Date	:	07/05/2010

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