Provider Demographics
NPI:1003949462
Name:PHAT DAT CORPORATION
Entity Type:Organization
Organization Name:PHAT DAT CORPORATION
Other - Org Name:NHA TRANG PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNY
Authorized Official - Middle Name:THANG
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:281-530-4500
Mailing Address - Street 1:6988 WILCREST DR
Mailing Address - Street 2:A-1
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-2625
Mailing Address - Country:US
Mailing Address - Phone:281-530-4500
Mailing Address - Fax:281-530-4502
Practice Address - Street 1:6988 WILCREST DR
Practice Address - Street 2:A-1
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-2625
Practice Address - Country:US
Practice Address - Phone:281-530-4500
Practice Address - Fax:281-530-4502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty