MEDICARE: JESSICA THUY HANG VU

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	65573	TX

General Provider Information

NPI Number	:	1639767353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA THUY HANG VU

Provider Business Mailing Address
First Line	:	4040 S BRAESWOOD BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-3304
Country	:	US
Telephone Number	:	713-666-6353
Fax Number	:

Provider Business Practice Location Address
First Line	:	4040 S BRAESWOOD BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-3304
Country	:	US
Telephone Number	:	713-666-6353
Fax Number	:

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

Provider Enumeration Date	:	01/07/2021
Last Update Date	:	01/07/2021

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Directions to “ JESSICA THUY HANG VU ” Practice Location

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