Provider Demographics
NPI:1316559867
Name:KANG, DAS HEY
Entity Type:Individual
Prefix:
First Name:DAS HEY
Middle Name:
Last Name:KANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 S VALLEY MILLS DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76711-1607
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1520 S VALLEY MILLS DR
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:TX
Practice Address - Zip Code:76711-1607
Practice Address - Country:US
Practice Address - Phone:254-752-3986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX59837183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist