Provider Demographics
NPI:1063000511
Name:MUHITCH, UYEN HA (R PH)
Entity Type:Individual
Prefix:
First Name:UYEN
Middle Name:HA
Last Name:MUHITCH
Suffix:
Gender:F
Credentials:R PH
Other - Prefix:
Other - First Name:UYEN
Other - Middle Name:PHUONG
Other - Last Name:HA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:R PH
Mailing Address - Street 1:6548 MEADOWBROOK DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76112-5125
Mailing Address - Country:US
Mailing Address - Phone:817-457-3680
Mailing Address - Fax:
Practice Address - Street 1:6548 MEADOWBROOK DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76112-5125
Practice Address - Country:US
Practice Address - Phone:817-457-3680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34780183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist