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NPI Code Detail

MEDICARE: CHARLES PHUC NGUYEN PHARM D

MEDICARE: CHARLES PHUC NGUYEN PHARM D
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
1183500000XPharmacist42650TX

General Provider Information

NPI Number : 1104155720
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES PHUC NGUYEN PHARM D
Provider Business Mailing Address
First Line : 13705 EVENING WIND DR
Second Line :
City : PEARLAND
State : TX
Zip : 77584-1769
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5280 BUFFALO SPEEDWAY
Second Line :
City : HOUSTON
State : TX
Zip : 77005-4204
Country : US
Telephone Number : 713-838-7704
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2009
Last Update Date : 12/10/2009

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