MEDICARE: ALLY NGUYEN RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	63656	TX

General Provider Information

NPI Number	:	1053938431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLY NGUYEN RPH

Provider Business Mailing Address
First Line	:	1436 WHITEWATER DR
Second Line	:
City	:	LITTLE ELM
State	:	TX
Zip	:	75068-7332
Country	:	US
Telephone Number	:	214-491-7962
Fax Number	:

Provider Business Practice Location Address
First Line	:	4691 STATE HIGHWAY 121
Second Line	:
City	:	THE COLONY
State	:	TX
Zip	:	75056-4010
Country	:	US
Telephone Number	:	972-625-3784
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2020
Last Update Date	:	07/01/2020

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Directions to “ ALLY NGUYEN RPH” Practice Location

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