Provider Demographics
NPI:1487258695
Name:LE, CHITHIEN BUITRUNG (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHITHIEN
Middle Name:BUITRUNG
Last Name:LE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1902 PLEASANT VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-3909
Mailing Address - Country:US
Mailing Address - Phone:972-675-0275
Mailing Address - Fax:
Practice Address - Street 1:1902 PLEASANT VALLEY RD
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-3909
Practice Address - Country:US
Practice Address - Phone:972-675-0275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-28
Last Update Date:2020-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD15073183500000X
FLPS61107183500000X
OKR-19015183500000X
TX65627183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist