Most Relevant Information
Provider Data
| NPI Number: | 1003571449 |
| Provider Name: | PHATRAWAN WONGSUWAN PHARMD |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 51803 |
Most Important Dates
| Enumeration Date: | 11/01/2021 |
| Last Updated: | 11/01/2021 |
Provider Practice Location
3100 SCHOFIELD RD
FORT SAM HOUSTON
TX
782347577
Practice Location Phone/Fax
| Phone: | 2108083551 |
| Fax: |
Provider Mailing Location
3100 SCHOFIELD RD BLDG 1179
FORT SAM HOUSTON
TX
782347577
Provider Mailing Phone/Fax
| Phone: | 2108083551 |
| Fax: |