Provider Demographics
NPI:1639514961
Name:CHAN, HONG-TA JAMES (RPH)
Entity Type:Individual
Prefix:
First Name:HONG-TA
Middle Name:JAMES
Last Name:CHAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13510 FIELD SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77059-3577
Mailing Address - Country:US
Mailing Address - Phone:281-480-3886
Mailing Address - Fax:
Practice Address - Street 1:927 E SHAW ROAD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77508
Practice Address - Country:US
Practice Address - Phone:713-982-5168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-30
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32605183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist