Provider Demographics
NPI:1114694957
Name:CAO, ALEXANDER THAI (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:THAI
Last Name:CAO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:ALEX
Other - Middle Name:THAI
Other - Last Name:CAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2216 ALABAMA ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66046-2857
Mailing Address - Country:US
Mailing Address - Phone:316-734-4941
Mailing Address - Fax:
Practice Address - Street 1:5311 SW 22ND PL
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-1500
Practice Address - Country:US
Practice Address - Phone:785-228-8762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-29
Last Update Date:2021-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-103743183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist