MEDICARE: MINH NGUYEN PHARM D

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	49363	TX

General Provider Information

NPI Number	:	1194009373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MINH NGUYEN PHARM D

Provider Business Mailing Address
First Line	:	6346 CAMP BOWIE BLVD
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76116-5408
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6346 CAMP BOWIE BLVD
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76116-5408
Country	:	US
Telephone Number	:	817-377-9095
Fax Number	:

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

Provider Enumeration Date	:	10/05/2011
Last Update Date	:	10/05/2011

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Directions to “ MINH NGUYEN PHARM D” Practice Location

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