Provider Demographics
NPI:1407168693
Name:PARK, KAREN HYECHIN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:HYECHIN
Last Name:PARK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 PRESTON AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-2051
Mailing Address - Country:US
Mailing Address - Phone:281-998-2100
Mailing Address - Fax:281-998-2101
Practice Address - Street 1:4001 PRESTON AVE STE 120
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-2051
Practice Address - Country:US
Practice Address - Phone:281-998-2100
Practice Address - Fax:281-998-2101
Is Sole Proprietor?:No
Enumeration Date:2010-07-05
Last Update Date:2010-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35166183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist