Provider Demographics
NPI:1366779423
Name:PAIK, KEE JOO (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KEE
Middle Name:JOO
Last Name:PAIK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KEEJOO
Other - Middle Name:
Other - Last Name:PAIK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:3301 DENTON HWY
Mailing Address - Street 2:WALGREENS.CO.
Mailing Address - City:HALTOM CITY
Mailing Address - State:TX
Mailing Address - Zip Code:76117-3200
Mailing Address - Country:US
Mailing Address - Phone:817-222-9247
Mailing Address - Fax:817-222-2948
Practice Address - Street 1:3301 DENTON HWY
Practice Address - Street 2:WALGREENS.CO.
Practice Address - City:HALTOM CITY
Practice Address - State:TX
Practice Address - Zip Code:76117-3200
Practice Address - Country:US
Practice Address - Phone:817-222-9247
Practice Address - Fax:817-222-2948
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX040370183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist