MEDICARE: BACH NGHIEM

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	43692	TX

General Provider Information

NPI Number	:	1750980553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BACH NGHIEM

Provider Business Mailing Address
First Line	:	2926 ROYAL OAKS CRST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77082-2840
Country	:	US
Telephone Number	:	832-557-5613
Fax Number	:

Provider Business Practice Location Address
First Line	:	9303 HIGHWAY 6 S
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-6381
Country	:	US
Telephone Number	:	713-474-2111
Fax Number	:

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

Provider Enumeration Date	:	10/22/2020
Last Update Date	:	10/22/2020

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Directions to “ BACH NGHIEM ” Practice Location

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