Provider Demographics
NPI:1821850363
Name:ZHENG, KENT
Entity Type:Individual
Prefix:
First Name:KENT
Middle Name:
Last Name:ZHENG
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 1:4800 TELLURIDE LN
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-5017
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11700 US HIGHWAY 380
Practice Address - Street 2:
Practice Address - City:CROSS ROADS
Practice Address - State:TX
Practice Address - Zip Code:76227-4642
Practice Address - Country:US
Practice Address - Phone:940-488-7008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73678183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist