MEDICARE: MYDUYEN 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	49057	TX

General Provider Information

NPI Number	:	1720682750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MYDUYEN NGUYEN PHARM.D.

Provider Business Mailing Address
First Line	:	3487 RAYFORD RD
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386
Country	:	US
Telephone Number	:	281-907-6036
Fax Number	:

Provider Business Practice Location Address
First Line	:	3487 RAYFORD RD
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-3649
Country	:	US
Telephone Number	:	281-907-6036
Fax Number	:

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

Provider Enumeration Date	:	11/30/2020
Last Update Date	:	11/30/2020

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