Provider Demographics
NPI:1902671654
Name:TENGIM, FLORY (LICENSED PHARMACIST)
Entity Type:Individual
Prefix:
First Name:FLORY
Middle Name:
Last Name:TENGIM
Suffix:
Gender:F
Credentials:LICENSED PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 W BELT LINE RD
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-4955
Mailing Address - Country:US
Mailing Address - Phone:972-230-3748
Mailing Address - Fax:972-230-4787
Practice Address - Street 1:731 W BELT LINE RD
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-4955
Practice Address - Country:US
Practice Address - Phone:972-230-3748
Practice Address - Fax:972-230-4787
Is Sole Proprietor?:No
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73447183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist