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NPI Code Detail

MEDICARE: MS. VICKI VAN MAI PHARMD.

MEDICARE:  MS. VICKI VAN MAI  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
1183500000XPharmacist183500000X45901TX

General Provider Information

NPI Number : 1649507708
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. VICKI VAN MAI PHARMD.
Provider Business Mailing Address
First Line : 705 WILLINGTON DR.
Second Line :
City : ARLINGTON
State : TX
Zip : 76018
Country : US
Telephone Number : 817-468-1551
Fax Number :
Provider Business Practice Location Address
First Line : 3809 E. BELKNAP ST.
Second Line :
City : FORT WORTH
State : TX
Zip : 76111
Country : US
Telephone Number : 817-834-7283
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2009
Last Update Date : 11/11/2009

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Directions to “ MS. VICKI VAN MAI PHARMD.” Practice Location

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