Provider Demographics
NPI:1598388423
Name:HUI, MICHELLE WAI-FONG (PHARMD)
Entity Type:Individual
Prefix:MISS
First Name:MICHELLE
Middle Name:WAI-FONG
Last Name:HUI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MISS
Other - First Name:WAI FONG
Other - Middle Name:
Other - Last Name:HUI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS PHARMACY, RPH
Mailing Address - Street 1:PO BOX 694
Mailing Address - Street 2:
Mailing Address - City:EAGLE BUTTE
Mailing Address - State:SD
Mailing Address - Zip Code:57625-0694
Mailing Address - Country:US
Mailing Address - Phone:972-487-5735
Mailing Address - Fax:972-487-5735
Practice Address - Street 1:24276 166TH STREET, AIRPORT ROAD
Practice Address - Street 2:
Practice Address - City:EAGLE BUTTE
Practice Address - State:SD
Practice Address - Zip Code:57625
Practice Address - Country:US
Practice Address - Phone:605-964-1520
Practice Address - Fax:605-964-7730
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30369183500000X, 1835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No183500000XPharmacy Service ProvidersPharmacist