Provider Demographics
NPI:1184818122
Name:LAI, PHILLIP H (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:H
Last Name:LAI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 E RUNDBERG LN
Mailing Address - Street 2:STE. B-1
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-4808
Mailing Address - Country:US
Mailing Address - Phone:512-978-9600
Mailing Address - Fax:512-978-9601
Practice Address - Street 1:825 E RUNDBERG LN
Practice Address - Street 2:STE. B-1
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753-4808
Practice Address - Country:US
Practice Address - Phone:512-978-9600
Practice Address - Fax:512-978-9601
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45478183500000X, 1835P1300X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric
No183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist