Provider Demographics
NPI:1578859005
Name:VO, ALICIA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:VO
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 1:4760 STATE HIGHWAY 121
Mailing Address - Street 2:TARGET PHARMACY STORE T-2520
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75056-2913
Mailing Address - Country:US
Mailing Address - Phone:469-287-0347
Mailing Address - Fax:469-287-0357
Practice Address - Street 1:4760 STATE HIGHWAY 121
Practice Address - Street 2:TARGET PHARMACY STORE T-2520
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75056-2913
Practice Address - Country:US
Practice Address - Phone:469-287-0347
Practice Address - Fax:469-287-0357
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44466183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist