MEDICARE: DR. MIKE HAO NGUYEN PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	40086	TX

General Provider Information

NPI Number	:	1063741890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MIKE HAO NGUYEN PHARMD

Provider Business Mailing Address
First Line	:	4323 SAN FELIPE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-3406
Country	:	US
Telephone Number	:	713-331-0166
Fax Number	:	713-345-1145

Provider Business Practice Location Address
First Line	:	4323 SAN FELIPE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-3406
Country	:	US
Telephone Number	:	713-331-0166
Fax Number	:	713-345-1145

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2009
Last Update Date	:	11/17/2020

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