Provider Demographics
NPI:1982011169
Name:CHAO, HOUT
Entity Type:Individual
Prefix:
First Name:HOUT
Middle Name:
Last Name:CHAO
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 1:11951 N 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85737-8593
Mailing Address - Country:US
Mailing Address - Phone:520-531-8964
Mailing Address - Fax:
Practice Address - Street 1:11951 N 1ST AVE
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85737-8593
Practice Address - Country:US
Practice Address - Phone:520-531-8964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-19
Last Update Date:2014-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS020625183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist