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General NPI Number Information
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NPI Number | 1477350072
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Entity Type | Individual
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Provider Name | CLINT TUAN NGUYEN RPH (PHARMD)
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Gender | Male
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Dates
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Enumeration Date | 03/01/2025
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Last Update Date | 03/01/2025
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Provider Practice Location Address
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Address Line | 106 N DENTON TAP RD
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City | COPPELL
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State | TX
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Zip | 75019-2138
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Country | US
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Telephone | 972-304-5564
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Fax |
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Provider Business Mailing Address
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Address Line | 3018 CROSS TIMBERS DR
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City | IRVING
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State | TX
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Zip | 75060-4714
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Country | US
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Telephone | 469-230-5272
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 75423
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License Number State | TX
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