Provider Demographics
NPI:1942800107
Name:PHAM, DUONG THUY (PHARMD)
Entity Type:Individual
Prefix:
First Name:DUONG
Middle Name:THUY
Last Name:PHAM
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 1:10826 OAK ACRES DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3174
Mailing Address - Country:US
Mailing Address - Phone:832-552-0255
Mailing Address - Fax:
Practice Address - Street 1:155 LOUETTA XING
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-3007
Practice Address - Country:US
Practice Address - Phone:281-651-0216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63392183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist