Provider Demographics
NPI:1083183321
Name:NGUYEN, VIVI (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:VIVI
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4645 PLANO PKWY APT 9214
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4962
Mailing Address - Country:US
Mailing Address - Phone:214-762-8172
Mailing Address - Fax:
Practice Address - Street 1:4001 LONG PRAIRIE RD STE 100
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1528
Practice Address - Country:US
Practice Address - Phone:469-771-4117
Practice Address - Fax:469-771-4118
Is Sole Proprietor?:No
Enumeration Date:2018-11-15
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47683183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist