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General NPI Number Information
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NPI Number | 1699442111
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Entity Type | Individual
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Provider Name | JIM NGUYEN RPH
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Gender | Male
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Dates
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Enumeration Date | 08/23/2021
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Last Update Date | 08/23/2021
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Provider Practice Location Address
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Address Line | 1921 S 77 SUNSHINESTRIP
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City | HARLINGEN
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State | TX
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Zip | 78550-8272
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Country | US
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Telephone | 956-365-3035
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Fax |
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Provider Business Mailing Address
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Address Line | 1407 SOUTHLINE ST
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City | CLEVELAND
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State | TX
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Zip | 77327-4652
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Country | US
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Telephone |
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 63738
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License Number State | TX
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