Provider Demographics
NPI:1205406378
Name:KHUU, VAN (PHARM D)
Entity Type:Individual
Prefix:
First Name:VAN
Middle Name:
Last Name:KHUU
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7916 BEACON KNOB WAY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78744-7802
Mailing Address - Country:US
Mailing Address - Phone:832-707-2005
Mailing Address - Fax:
Practice Address - Street 1:6911 RR 620 N
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78732-1920
Practice Address - Country:US
Practice Address - Phone:512-219-8699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68216183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist