Healthcare Provider Details

I. General information

NPI: 1487569331
Provider Name (Legal Business Name): SEAN NGUYEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 N CENTRAL EXPY
PLANO TX
75074-2221
US

IV. Provider business mailing address

1107 SADDLEBROOK DR
MURPHY TX
75094-4179
US

V. Phone/Fax

Practice location:
  • Phone: 972-244-0002
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number77679
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: