Healthcare Provider Details

I. General information

NPI: 1316261407
Provider Name (Legal Business Name): NAM QUOC NGUYEN PHARM. D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2010
Last Update Date: 03/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 S 10TH ST
MCALLEN TX
78503-5401
US

IV. Provider business mailing address

603 S LOGAN DR APT 2
EDINBURG TX
78539-0985
US

V. Phone/Fax

Practice location:
  • Phone: 956-661-1351
  • Fax: 956-661-1132
Mailing address:
  • Phone: 713-493-1296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number41867
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: