Individual
DR. KEUMBOH (KIM) TANGU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD, BCPP
Taxonomy
Speciality
Code
Description
License number
State
1835P1300X
Psychiatric Pharmacist
Primary
45059
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
884433
BOARD OF PHARMACY SPECIALTIES (BPS)
—
Enumeration date
06/03/2011
Last updated
11/01/2019
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