Provider Demographics
NPI:1700114766
Name:FANGTANG, JOHN TAFFOU (PHARMD; DRPH)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:TAFFOU
Last Name:FANGTANG
Suffix:
Gender:M
Credentials:PHARMD; DRPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12606 WESTPARK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-5526
Mailing Address - Country:US
Mailing Address - Phone:281-558-5653
Mailing Address - Fax:281-558-6309
Practice Address - Street 1:12606 WESTPARK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-5526
Practice Address - Country:US
Practice Address - Phone:281-558-5653
Practice Address - Fax:281-558-6309
Is Sole Proprietor?:No
Enumeration Date:2009-12-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26369183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist