Provider Demographics
NPI:1366820896
Name:PHAM, NGOC-THUY THI (PHARMD)
Entity Type:Individual
Prefix:
First Name:NGOC-THUY
Middle Name:THI
Last Name:PHAM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3885 DOWLEN RD
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-6604
Mailing Address - Country:US
Mailing Address - Phone:409-924-7570
Mailing Address - Fax:409-924-7595
Practice Address - Street 1:3885 DOWLEN RD
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-6604
Practice Address - Country:US
Practice Address - Phone:409-924-7570
Practice Address - Fax:409-924-7595
Is Sole Proprietor?:No
Enumeration Date:2015-05-17
Last Update Date:2015-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX55151183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist