MEDICARE: MISS YHANH NGUYEN PHARMACIST

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	35631	TX

General Provider Information

NPI Number	:	1326047390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS YHANH NGUYEN PHARMACIST

Provider Business Mailing Address
First Line	:	12110 RYEWATER DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77089-6520
Country	:	US
Telephone Number	:	281-484-1464
Fax Number	:

Provider Business Practice Location Address
First Line	:	4655 ALDINE MAIL ROUTE RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77039-5942
Country	:	US
Telephone Number	:	281-985-7670
Fax Number	:

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

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	08/29/2007

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