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General NPI Number Information
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NPI Number | 1649776675
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Entity Type | Individual
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Provider Name | QUYNH-NHI THI NGUYEN
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Gender | Female
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Dates
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Enumeration Date | 03/30/2018
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Last Update Date | 07/30/2024
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Provider Practice Location Address
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Address Line | 1275 W TERRELL AVE
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City | FORT WORTH
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State | TX
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Zip | 76104
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Country | US
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Telephone | 817-250-7035
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Fax |
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Provider Business Mailing Address
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Address Line | 4511 JACKSON MEADOWS DR
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City | SACHSE
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State | TX
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Zip | 75048-4587
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Country | US
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Telephone | 972-533-7825
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 67365
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License Number State | TX
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