MEDICARE: HONG CAM BROD 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	40893	TX

General Provider Information

NPI Number	:	1770812406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HONG CAM BROD PHARM. D

Provider Business Mailing Address
First Line	:	1700 OLD RANCH ROAD 12
Second Line	:
City	:	SAN MARCOS
State	:	TX
Zip	:	78666-2502
Country	:	US
Telephone Number	:	512-393-3701
Fax Number	:	512-933-7073

Provider Business Practice Location Address
First Line	:	1700 OLD RANCH ROAD 12
Second Line	:
City	:	SAN MARCOS
State	:	TX
Zip	:	78666-2502
Country	:	US
Telephone Number	:	512-393-3701
Fax Number	:	512-933-7073

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

Provider Enumeration Date	:	12/08/2009
Last Update Date	:	12/20/2022

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