Provider Demographics
NPI:1336993872
Name:KORZEC, KALINA QIU JU (PHARMD)
Entity Type:Individual
Prefix:
First Name:KALINA
Middle Name:QIU JU
Last Name:KORZEC
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 1:9111 LAKES AT 610 DR APT 1136
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2426
Mailing Address - Country:US
Mailing Address - Phone:802-379-7250
Mailing Address - Fax:
Practice Address - Street 1:6565 FANNIN STREET
Practice Address - Street 2:PHARMACY DEPARTMENT DUNN BASEMENT
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:802-379-7250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72960183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist