MEDICARE: PHUONG THUY PHAM PHARM D

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	42476	TX

General Provider Information

NPI Number	:	1679800510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHUONG THUY PHAM PHARM D

Provider Business Mailing Address
First Line	:	6402 FM 1960 RD W
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77069-3902
Country	:	US
Telephone Number	:	281-631-9736
Fax Number	:	281-631-9505

Provider Business Practice Location Address
First Line	:	6402 FM 1960 RD W
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77069-3902
Country	:	US
Telephone Number	:	281-631-9736
Fax Number	:	281-631-9505

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

Provider Enumeration Date	:	11/13/2009
Last Update Date	:	11/13/2009

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Directions to “ PHUONG THUY PHAM PHARM D” Practice Location

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