Provider Demographics
NPI:1245568096
Name:DIEP, ANDY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDY
Middle Name:
Last Name:DIEP
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 1:9705 SPENCER HWY
Mailing Address - Street 2:
Mailing Address - City:LA PORTE
Mailing Address - State:TX
Mailing Address - Zip Code:77571-4071
Mailing Address - Country:US
Mailing Address - Phone:281-470-7428
Mailing Address - Fax:
Practice Address - Street 1:9705 SPENCER HWY
Practice Address - Street 2:
Practice Address - City:LA PORTE
Practice Address - State:TX
Practice Address - Zip Code:77571-4071
Practice Address - Country:US
Practice Address - Phone:281-470-7428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-04
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41022183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist