Healthcare Provider Details

I. General information

NPI: 1962013508
Provider Name (Legal Business Name): THERESA NGUYEN DAO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2020
Last Update Date: 12/31/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27000 TOMBALL PKWY
HOUSTON TX
77375
US

IV. Provider business mailing address

27000 TOMBALL PKWY
TOMBALL TX
77375-2116
US

V. Phone/Fax

Practice location:
  • Phone: 328-430-8058
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number65158
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: