Truong Phan Enterprise LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

25799 Issued in TX

Legal business name

TRUONG PHAN ENTERPRISE LLC

Doing business as

Country Place Pharmacy

Practice address

2404 Smith Ranch Rd Ste 100
Pearland, TX 77584-5233

Phone

(713) 436-3344

Fax

(713) 436-3803

NPI assigned

Sep 20, 2006

Last updated

Sep 12, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Chau Phan

Title

President

Phone

(832) 524-5427

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• COUNTRY PLACE PHARMACY Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347408000000",
    "number": "1205933041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11011 HUNDRED BRIDGE LN",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774987229",
            "telephone_number": "713-436-3344",
            "fax_number": "713-436-3803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 SMITH RANCH RD STE 100",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775845233",
            "telephone_number": "713-436-3344",
            "fax_number": "713-436-3803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUONG PHAN ENTERPRISE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2012-09-12",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "CHAU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "832-524-5427"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "25799",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145559",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4537897",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COUNTRY PLACE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carl Lawrence Trube, APRN
• Kristina Michelle Trudeau
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• Trang Hoang Truong, O.D
• James Irwin Trussell III, D.C
• Trustbridge Home Care LLC
• Peiying Isabella Tsai
• Tuan D. Dang, OD, PA

• Community/Retail Pharmacy in Pearland, TX
• Providers in Pearland, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.