MEDICARE: DR. DANTHANH T VU 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	41746	TX

General Provider Information

NPI Number	:	1689901944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANTHANH T VU PHARM. D.

Provider Business Mailing Address
First Line	:	13714 TOMBALL PKWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77086-2706
Country	:	US
Telephone Number	:	281-448-7005
Fax Number	:	281-448-2517

Provider Business Practice Location Address
First Line	:	13714 TOMBALL PKWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77086-2706
Country	:	US
Telephone Number	:	281-448-7005
Fax Number	:	281-448-2517

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

Provider Enumeration Date	:	11/06/2009
Last Update Date	:	11/06/2009

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