Individual
CHANTHY BUTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1372 BELT LINE RD, GARLAND, TX 75040-3266
(972) 495-1933
Mailing address
4505 SEA SPARROW LN, GARLAND, TX 75043-2679
(209) 670-4266
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
56485
TX
Other
Enumeration date
11/30/2020
Last updated
11/30/2020
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