Provider Demographics
NPI:1396345187
Name:CAO, AILEEN THI (RPH)
Entity type:Individual
Prefix:
First Name:AILEEN
Middle Name:THI
Last Name:CAO
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 1:155 W EL DORADO BLVD
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-6502
Mailing Address - Country:US
Mailing Address - Phone:281-286-4517
Mailing Address - Fax:281-286-4540
Practice Address - Street 1:155 W EL DORADO BLVD
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-6502
Practice Address - Country:US
Practice Address - Phone:281-286-4517
Practice Address - Fax:281-286-4540
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX46670183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist