Individual
DONNA DUYEN PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3220 DENTON HWY, HALTOM CITY, TX 76117-3717
(817) 831-4488
Mailing address
4825 EDDLEMAN DR, FORT WORTH, TX 76244-9122
(817) 781-5937
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
39639
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760586556
1760586556
TX
Enumeration date
11/30/2020
Last updated
11/30/2020
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