Provider Demographics
NPI:1558358192
Name:HA, THE KE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:THE
Middle Name:KE
Last Name:HA
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 1:4201 FLAMINGO DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-4605
Mailing Address - Country:US
Mailing Address - Phone:254-383-4348
Mailing Address - Fax:
Practice Address - Street 1:4201 FLAMINGO DR
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-4605
Practice Address - Country:US
Practice Address - Phone:254-383-4348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003023561183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist