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NPI Code Detail

MEDICARE: KIM MINH THI NGUYEN PHARMD

MEDICARE: KIM MINH THI NGUYEN PHARMD
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
1183500000XPharmacist59530TX

General Provider Information

NPI Number : 1932732872
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIM MINH THI NGUYEN PHARMD
Provider Business Mailing Address
First Line : 3425 SYCAMORE SCHOOL RD
Second Line :
City : FORT WORTH
State : TX
Zip : 76123-3030
Country : US
Telephone Number : 817-370-0505
Fax Number :
Provider Business Practice Location Address
First Line : 3425 SYCAMORE SCHOOL RD
Second Line :
City : FORT WORTH
State : TX
Zip : 76123-3030
Country : US
Telephone Number : 817-370-0505
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2020
Last Update Date : 02/19/2020

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