Healthcare Provider Details

I. General information

NPI: 1144151101
Provider Name (Legal Business Name): KRISTINA D NGUYEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22407 HOLZWARTH RD
SPRING TX
77389-1933
US

IV. Provider business mailing address

22407 HOLZWARTH RD
SPRING TX
77389-1933
US

V. Phone/Fax

Practice location:
  • Phone: 346-674-4151
  • Fax:
Mailing address:
  • Phone: 346-674-4151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number65217
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: