Provider Demographics
NPI:1962017236
Name:LAM, PHUONG T (RPH)
Entity Type:Individual
Prefix:
First Name:PHUONG
Middle Name:T
Last Name:LAM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19602 LAUREL PARK LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77094-3035
Mailing Address - Country:US
Mailing Address - Phone:512-800-2987
Mailing Address - Fax:
Practice Address - Street 1:5249 FRANZ RD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-1756
Practice Address - Country:US
Practice Address - Phone:281-391-7051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-13
Last Update Date:2020-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61044183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist