Provider Demographics
NPI:1710589973
Name:VUONG, LAWRENCE (PHARM D)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:VUONG
Suffix:
Gender:M
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 1:6361 NAAMAN FOREST BLVD APT 12312
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-5746
Mailing Address - Country:US
Mailing Address - Phone:817-903-3199
Mailing Address - Fax:
Practice Address - Street 1:1855 S GARLAND AVE
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-7648
Practice Address - Country:US
Practice Address - Phone:972-535-1429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX49669183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist