Provider Demographics
NPI:1932684396
Name:ZHAO, DAN (RPH)
Entity Type:Individual
Prefix:
First Name:DAN
Middle Name:
Last Name:ZHAO
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 1:4109 CITY POINT DR STE E
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-8339
Mailing Address - Country:US
Mailing Address - Phone:817-612-1490
Mailing Address - Fax:817-840-6419
Practice Address - Street 1:5804 COIT RD STE 100
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-5955
Practice Address - Country:US
Practice Address - Phone:469-931-2253
Practice Address - Fax:469-931-2246
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63335183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist