Provider Demographics
NPI:1841921244
Name:LAM, TU-KHANH
Entity type:Individual
Prefix:
First Name:TU-KHANH
Middle Name:
Last Name:LAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1828 MEADOW CREST DR
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-7059
Mailing Address - Country:US
Mailing Address - Phone:682-802-6766
Mailing Address - Fax:
Practice Address - Street 1:11920 PRESTON RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2799
Practice Address - Country:US
Practice Address - Phone:972-980-4915
Practice Address - Fax:972-392-1506
Is Sole Proprietor?:No
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70518183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist