Provider Demographics
NPI:1083982003
Name:ZHANG, GUANG HAI (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:GUANG
Middle Name:HAI
Last Name:ZHANG
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:MR
Other - First Name:JERRY
Other - Middle Name:H
Other - Last Name:ZHANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:5760 WALZEM RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-2107
Mailing Address - Country:US
Mailing Address - Phone:210-657-7071
Mailing Address - Fax:
Practice Address - Street 1:5760 WALZEM RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218-2107
Practice Address - Country:US
Practice Address - Phone:210-657-7071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX48843183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist