Provider Demographics
NPI:1811343205
Name:CHEA, THEIRY (PHARMD)
Entity type:Individual
Prefix:
First Name:THEIRY
Middle Name:
Last Name:CHEA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 SUNSET AVE
Mailing Address - Street 2:SUITE 118A
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-4599
Mailing Address - Country:US
Mailing Address - Phone:214-943-5187
Mailing Address - Fax:
Practice Address - Street 1:219 SUNSET AVE
Practice Address - Street 2:SUITE 118A
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-4599
Practice Address - Country:US
Practice Address - Phone:214-943-5187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX55495183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist