Healthcare Provider Details

I. General information

NPI: 1235938978
Provider Name (Legal Business Name): HUY QUANG NGUYEN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2025
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 S EDDY ST UNIT A
PECOS TX
79772-3709
US

IV. Provider business mailing address

1010 S EDDY ST UNIT A
PECOS TX
79772-3709
US

V. Phone/Fax

Practice location:
  • Phone: 432-447-2266
  • Fax:
Mailing address:
  • Phone: 432-447-2266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number62816
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: