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NPI Code Detail

MEDICARE: MRS. SUONG THU THI THAI PHARM D.

MEDICARE: MRS. SUONG THU THI THAI 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
1183500000XPharmacist44174TX
2183500000XPharmacist57705CA

General Provider Information

NPI Number : 1871887133
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUONG THU THI THAI PHARM D.
Provider Business Mailing Address
First Line : 2700 ELDRIDGE PKWY
Second Line : T-2419
City : HOUSTON
State : TX
Zip : 77082-6870
Country : US
Telephone Number : 281-810-5252
Fax Number : 281-810-5262
Provider Business Practice Location Address
First Line : 2700 ELDRIDGE PKWY
Second Line : T-2419
City : HOUSTON
State : TX
Zip : 77082-6870
Country : US
Telephone Number : 281-810-5252
Fax Number : 281-810-5262
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2011
Last Update Date : 06/04/2011

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