Provider Demographics
NPI:1083251995
Name:HAAS-HUYNH, KRISTEN MICHELLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:MICHELLE
Last Name:HAAS-HUYNH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:KRISTEN
Other - Middle Name:MICHELLE
Other - Last Name:HAAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:511 N STEWART ST
Mailing Address - Street 2:
Mailing Address - City:AZLE
Mailing Address - State:TX
Mailing Address - Zip Code:76020-3237
Mailing Address - Country:US
Mailing Address - Phone:817-444-0306
Mailing Address - Fax:817-444-0964
Practice Address - Street 1:511 N STEWART ST
Practice Address - Street 2:
Practice Address - City:AZLE
Practice Address - State:TX
Practice Address - Zip Code:76020-3237
Practice Address - Country:US
Practice Address - Phone:817-444-0306
Practice Address - Fax:817-444-0964
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX56723183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist