Provider Demographics
NPI:1902535313
Name:CHAU, ANH LAN
Entity Type:Individual
Prefix:
First Name:ANH
Middle Name:LAN
Last Name:CHAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 CONFLANS RD # 210
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-6324
Mailing Address - Country:US
Mailing Address - Phone:469-340-4030
Mailing Address - Fax:
Practice Address - Street 1:3600 CONFLANS RD # 210
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-6324
Practice Address - Country:US
Practice Address - Phone:469-340-4030
Practice Address - Fax:469-706-3371
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36644183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist