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General NPI Number Information
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NPI Number | 1649527342
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Entity Type | Individual
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Provider Name | TERRY X NGUYEN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/13/2012
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Last Update Date | 01/09/2024
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Provider Practice Location Address
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Address Line | 4864 JACKSON STREET RM.1-161A
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City | MONROE
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State | LA
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Zip | 71202-6400
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Country | US
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Telephone | 318-330-7141
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Fax |
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Provider Business Mailing Address
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Address Line | 4864 JACKSON ST RM 1161A
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City | MONROE
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State | LA
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Zip | 71202-6400
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Country | US
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Telephone | 318-330-7969
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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 | PST.019757
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License Number State | LA
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