Individual
DANH PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1301 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2122
(817) 250-2089
Mailing address
2868 FIELDSTONE DR, GRAND PRAIRIE, TX 75052-8887
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
74184
TX
Other
Enumeration date
07/05/2024
Last updated
07/05/2024
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