Provider Demographics
NPI:1821399437
Name:ING, USSAH ANDREW
Entity Type:Individual
Prefix:
First Name:USSAH
Middle Name:ANDREW
Last Name:ING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 BAYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77009-6601
Mailing Address - Country:US
Mailing Address - Phone:713-861-4121
Mailing Address - Fax:
Practice Address - Street 1:307 BAYLAND AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77009-6601
Practice Address - Country:US
Practice Address - Phone:713-861-4121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-12
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43326183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist