Provider Demographics
NPI:1619204799
Name:PHAM, HONG CAM (RPH)
Entity Type:Individual
Prefix:MRS
First Name:HONG
Middle Name:CAM
Last Name:PHAM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 E FRANKFORD RD
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-5334
Mailing Address - Country:US
Mailing Address - Phone:972-394-9273
Mailing Address - Fax:
Practice Address - Street 1:1919 E FRANKFORD RD
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-5334
Practice Address - Country:US
Practice Address - Phone:972-394-9273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-10
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42926183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist