MEDICARE: KHA 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	47820	TX

General Provider Information

NPI Number	:	1619205747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KHA NGUYEN PHARM D

Provider Business Mailing Address
First Line	:	4007 BARKER CYPRESS RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-6802
Country	:	US
Telephone Number	:	281-550-9804
Fax Number	:

Provider Business Practice Location Address
First Line	:	4007 BARKER CYPRESS RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-6802
Country	:	US
Telephone Number	:	281-550-9804
Fax Number	:

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

Provider Enumeration Date	:	12/01/2009
Last Update Date	:	10/04/2011

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