Provider Demographics
NPI:1003145434
Name:NGUYEN, JEANMARC V (PHARMD)
Entity Type:Individual
Prefix:
First Name:JEANMARC
Middle Name:V
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 TAYLORCREST
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-6929
Mailing Address - Country:US
Mailing Address - Phone:324-668-8158
Mailing Address - Fax:
Practice Address - Street 1:9460 W SAM HOUSTON PKWY S
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-1850
Practice Address - Country:US
Practice Address - Phone:281-568-3134
Practice Address - Fax:281-568-6974
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-14
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44925183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist