Provider Demographics
NPI:1639513393
Name:PHAN, KAILE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:KAILE
Middle Name:
Last Name:PHAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4755 ALDINE MAIL RD
Mailing Address - Street 2:PHARMACY
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77039-5934
Mailing Address - Country:US
Mailing Address - Phone:281-985-7652
Mailing Address - Fax:281-985-7796
Practice Address - Street 1:4755 ALDINE MAIL RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77039-5934
Practice Address - Country:US
Practice Address - Phone:281-985-7652
Practice Address - Fax:281-985-7796
Is Sole Proprietor?:No
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50469183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist