Most Relevant Information
Provider Data
| NPI Number: | 1003589334 |
| Provider Name: | KRISTINE PHAM |
| Entity Type: | Individual |
| Taxonomy Code: | 183700000X |
| Specialty: | Pharmacy Technician |
| License Number: | 235906 |
Most Important Dates
| Enumeration Date: | 08/02/2021 |
| Last Updated: | 08/02/2021 |
Provider Practice Location
4800B HIGHWAY 365
PORT ARTHUR
TX
776427403
Practice Location Phone/Fax
| Phone: | 4097221369 |
| Fax: |
Provider Mailing Location
4800B HIGHWAY 365
PORT ARTHUR
TX
776427403
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |