Provider Demographics
NPI:1902436751
Name:HOANG, LANCE NAM
Entity Type:Individual
Prefix:DR
First Name:LANCE
Middle Name:NAM
Last Name:HOANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10909 FONDREN RD APT 409
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-5565
Mailing Address - Country:US
Mailing Address - Phone:281-961-8653
Mailing Address - Fax:
Practice Address - Street 1:10909 FONDREN RD APT 409
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-5565
Practice Address - Country:US
Practice Address - Phone:281-961-8653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-21
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64184183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist