Provider Demographics
NPI:1609590090
Name:VO, STACY THI (PHARM D)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:THI
Last Name:VO
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:NAM
Other - Middle Name:THI
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:25110 GROGANS MILL RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2248
Mailing Address - Country:US
Mailing Address - Phone:281-363-2290
Mailing Address - Fax:
Practice Address - Street 1:25110 GROGANS MILL RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-2248
Practice Address - Country:US
Practice Address - Phone:281-363-2290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53954183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist