Provider Demographics
NPI:1003411844
Name:KHUON, KANIDA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KANIDA
Middle Name:
Last Name:KHUON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8818 CHARNEY LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77088-3214
Mailing Address - Country:US
Mailing Address - Phone:832-868-5730
Mailing Address - Fax:
Practice Address - Street 1:5659 LEMMON AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75209-6225
Practice Address - Country:US
Practice Address - Phone:214-252-0121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61304183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist