Provider Demographics
NPI:1396073482
Name:TIEU, KGEARG LEE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KGEARG
Middle Name:LEE
Last Name:TIEU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KGEARNG KAREN
Other - Middle Name:LEE
Other - Last Name:TIEU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11633 SHADOW CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7262
Mailing Address - Country:US
Mailing Address - Phone:713-436-4913
Mailing Address - Fax:713-436-3945
Practice Address - Street 1:11633 SHADOW CREEK PKWY
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7262
Practice Address - Country:US
Practice Address - Phone:713-436-4913
Practice Address - Fax:713-436-3945
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-30
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45334183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist