Provider Demographics
NPI:1275096018
Name:UKHUN, IMEINE A (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:IMEINE
Middle Name:A
Last Name:UKHUN
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 1:3906 CANTON CT
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76208-7570
Mailing Address - Country:US
Mailing Address - Phone:903-517-7312
Mailing Address - Fax:
Practice Address - Street 1:3906 CANTON CT
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76208-7570
Practice Address - Country:US
Practice Address - Phone:903-517-7312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX344141835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Single Specialty