Provider Demographics
NPI:1790330173
Name:NGAC, TAM THANH (PHARMD)
Entity Type:Individual
Prefix:
First Name:TAM
Middle Name:THANH
Last Name:NGAC
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 MEMORIAL HEIGHTS DR APT 5106
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-6091
Mailing Address - Country:US
Mailing Address - Phone:832-310-9828
Mailing Address - Fax:
Practice Address - Street 1:3745 WESTHEIMER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-5227
Practice Address - Country:US
Practice Address - Phone:713-629-0703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-02
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65220183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist