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NPI Code Detail

MEDICARE: DIEM KHANH NGUYEN RPH

MEDICARE:   DIEM KHANH 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
1183500000XPharmacist33504TX

General Provider Information

NPI Number : 1568746741
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIEM KHANH NGUYEN RPH
Provider Business Mailing Address
First Line : 2050 LONG PRAIRIE RD
Second Line :
City : FLOWER MOUND
State : TX
Zip : 75022-4221
Country : US
Telephone Number : 972-355-4831
Fax Number : 972-355-4482
Provider Business Practice Location Address
First Line : 2050 LONG PRAIRIE RD
Second Line :
City : FLOWER MOUND
State : TX
Zip : 75022-4221
Country : US
Telephone Number : 972-355-4831
Fax Number : 972-355-4482
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2011
Last Update Date : 05/07/2016

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