Provider Demographics
NPI:1821693755
Name:VO, HAIYEN
Entity Type:Individual
Prefix:
First Name:HAIYEN
Middle Name:
Last Name:VO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 MARINA BAY DR
Mailing Address - Street 2:
Mailing Address - City:CLEAR LAKE SHORES
Mailing Address - State:TX
Mailing Address - Zip Code:77565-2671
Mailing Address - Country:US
Mailing Address - Phone:832-420-8818
Mailing Address - Fax:
Practice Address - Street 1:255 MARINA BAY DR
Practice Address - Street 2:
Practice Address - City:CLEAR LAKE SHORES
Practice Address - State:TX
Practice Address - Zip Code:77565-2671
Practice Address - Country:US
Practice Address - Phone:281-538-7957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX59066183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist