MEDICARE: ASHLEY DINH

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	35431	TX

General Provider Information

NPI Number	:	1063917656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY DINH

Provider Business Mailing Address
First Line	:	4305 DUVAL ST APT 104
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78751-3901
Country	:	US
Telephone Number	:	281-691-3562
Fax Number	:

Provider Business Practice Location Address
First Line	:	4305 DUVAL ST APT 104
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78751-3901
Country	:	US
Telephone Number	:	281-691-3562
Fax Number	:

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

Provider Enumeration Date	:	03/27/2018
Last Update Date	:	03/27/2018

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Directions to “ ASHLEY DINH ” Practice Location

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