Organization
NDC PHARMACY
Active
Organization
NDC PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHANH HOANG PHARM D (PHARMACIST IN CHARGE)
(469) 888-4672
Entity
Organization
Contact information
Practice address
4666 MCDERMOTT RD STE 200, PLANO, TX 75024-7772
(469) 888-4672
(469) 888-4672
Mailing address
4666 MCDERMOTT RD, 200, PLANO, TX 75024
(972) 517-7900
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
31750
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31750
TEXAS BOARD OF PHARMACY
TX
Enumeration date
12/13/2017
Last updated
04/11/2019
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