=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609103670
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LILY NGUYEN LE R.PH.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/11/2009
-----------------------------------------------------
Last Update Date | 11/11/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 101 W UNIVERSITY DR
-----------------------------------------------------
City | DENTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76201-1809
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 940-384-0240
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1129 HYANNIS ST
-----------------------------------------------------
City | PLANO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75094-4593
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-924-9373
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 39313
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------