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NPI Code Detail

MEDICARE: THERESA NGUYET TIEN KOBER

MEDICARE: THERESA NGUYET TIEN KOBER
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
1183500000XPharmacistPST.020656LA

General Provider Information

NPI Number : 1588063770
Entity Type Code : Individual
Provider Name (Legal Business Name) : THERESA NGUYET TIEN KOBER
Provider Business Mailing Address
First Line : 973 HIGHWAY 90 E
Second Line :
City : MORGAN CITY
State : LA
Zip : 70380-5156
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 973 HIGHWAY 90 E
Second Line :
City : MORGAN CITY
State : LA
Zip : 70380-5156
Country : US
Telephone Number : 985-395-9625
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2014
Last Update Date : 06/09/2022

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Directions to “ THERESA NGUYET TIEN KOBER ” Practice Location

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