Provider Demographics
NPI:1790493427
Name:HE, SOPHONNARY (PHARMD)
Entity Type:Individual
Prefix:
First Name:SOPHONNARY
Middle Name:
Last Name:HE
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 1:1802 DELTA OAKS DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-2486
Mailing Address - Country:US
Mailing Address - Phone:806-283-6013
Mailing Address - Fax:
Practice Address - Street 1:1919 W GRAY ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019-4801
Practice Address - Country:US
Practice Address - Phone:806-283-6013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71655183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist