Healthcare Provider Details

I. General information

NPI: 1811514250
Provider Name (Legal Business Name): YEN HOANG NGUYEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2020
Last Update Date: 07/01/2020
Certification Date: 07/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

865 DESHONG DR
PARIS TX
75460-9313
US

IV. Provider business mailing address

3555 RUBY WAY APT 9201
PARIS TX
75460-3358
US

V. Phone/Fax

Practice location:
  • Phone: 903-785-4521
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number63200
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: