Provider Demographics
NPI:1568086478
Name:LE, KHANH CHUONG (PHARMD)
Entity Type:Individual
Prefix:
First Name:KHANH
Middle Name:CHUONG
Last Name:LE
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 1:6850 N SHILOH RD
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-2912
Mailing Address - Country:US
Mailing Address - Phone:972-496-4503
Mailing Address - Fax:972-496-4303
Practice Address - Street 1:6850 N SHILOH RD
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-2912
Practice Address - Country:US
Practice Address - Phone:972-496-4503
Practice Address - Fax:972-496-4303
Is Sole Proprietor?:No
Enumeration Date:2020-06-05
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX533091835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist