Provider Demographics
NPI:1780901462
Name:POON, SANDRA LIZA (PHARMD)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:LIZA
Last Name:POON
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 1:11815 WESTHEIMER RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-6860
Mailing Address - Country:US
Mailing Address - Phone:281-497-8479
Mailing Address - Fax:281-497-9454
Practice Address - Street 1:11815 WESTHEIMER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-6860
Practice Address - Country:US
Practice Address - Phone:281-497-8479
Practice Address - Fax:281-497-9454
Is Sole Proprietor?:No
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX46513183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist