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General NPI Number Information
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NPI Number | 1578974663
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Entity Type | Organization
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Legal Business Name | LAN NGOC NGUYEN, PHARM.D.,,LLC
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Dates
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Enumeration Date | 05/12/2014
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Last Update Date | 05/12/2014
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Provider Practice Location Address
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Address Line | 1102 ORCHARD DR. SUITE B
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City | ARLINGTON
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State | TX
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Zip | 76012
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Country | US
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Telephone | 817-617-3460
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Fax | 817-617-3458
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Provider Business Mailing Address
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Address Line | 1102 ORCHARD DR SUITE B
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City | ARLINGTON
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State | TX
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Zip | 76012
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Country | US
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Telephone | 817-617-3460
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Fax | 817-617-3458
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Authorized Official
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Title or Position | PHARMACIST
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Name | MRS. LAN NGOC NGUYEN
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Credential | PHARMD
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Telephone | 817-617-3460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 29254
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License Number State | TX
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