MEDICARE: DAVID L FUNG RPH

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	49724	TX

General Provider Information

NPI Number	:	1790381911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID L FUNG RPH

Provider Business Mailing Address
First Line	:	10113 CHICAGO AVE
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79424-8254
Country	:	US
Telephone Number	:	813-244-9882
Fax Number	:

Provider Business Practice Location Address
First Line	:	3436 34TH ST
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79410-2830
Country	:	US
Telephone Number	:	806-799-3636
Fax Number	:	806-795-4622

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

Provider Enumeration Date	:	12/11/2020
Last Update Date	:	12/11/2020

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Directions to “ DAVID L FUNG RPH” Practice Location

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