Provider Demographics
NPI:1932604337
Name:GUAN, SYLVIA LEE (PHARMD)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:LEE
Last Name:GUAN
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 1:2012 MAIZE BEND DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-3449
Mailing Address - Country:US
Mailing Address - Phone:504-919-5055
Mailing Address - Fax:
Practice Address - Street 1:1812 CENTRE CREEK DR STE 115
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-5133
Practice Address - Country:US
Practice Address - Phone:520-686-5789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45482183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist