Provider Demographics
NPI:1053486837
Name:NGUYEN, VINCENT TRUNG (RPH)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:TRUNG
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3707 HUNTLAND CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-1012
Mailing Address - Country:US
Mailing Address - Phone:281-398-9576
Mailing Address - Fax:
Practice Address - Street 1:1350 FIRST COLONY BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-4308
Practice Address - Country:US
Practice Address - Phone:281-276-3467
Practice Address - Fax:281-276-3494
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX334061835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology