MEDICARE: MRS. THANH HUONG T 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	44498	TX
2	183500000X	Pharmacist	E-010083	MS

General Provider Information

NPI Number	:	1194052019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. THANH HUONG T NGUYEN PHARMD

Provider Business Mailing Address
First Line	:	720 WEST FM 544
Second Line	:
City	:	WYLIE
State	:	TX
Zip	:	75098
Country	:	US
Telephone Number	:	972-429-7949
Fax Number	:

Provider Business Practice Location Address
First Line	:	720 W FM 544
Second Line	:
City	:	WYLIE
State	:	TX
Zip	:	75098-3913
Country	:	US
Telephone Number	:	972-429-7949
Fax Number	:

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

Provider Enumeration Date	:	11/13/2009
Last Update Date	:	11/13/2009

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