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NPI Code Detail

MEDICARE: MR. KHANH DUY NGUYEN

MEDICARE: MR. KHANH DUY NGUYEN
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
1183500000XPharmacist37562TX

General Provider Information

NPI Number : 1619205176
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KHANH DUY NGUYEN
Provider Business Mailing Address
First Line : 5280 BUFFALO SPEEDWAY
Second Line :
City : HOUSTON
State : TX
Zip : 77005-4204
Country : US
Telephone Number : 713-838-7704
Fax Number : 713-838-7709
Provider Business Practice Location Address
First Line : 5280 BUFFALO SPEEDWAY
Second Line :
City : HOUSTON
State : TX
Zip : 77005-4204
Country : US
Telephone Number : 713-838-7704
Fax Number : 713-838-7709
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2009
Last Update Date : 11/20/2009

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