Provider Demographics
NPI:1134291933
Name:NGA NGUYEN
Entity Type:Organization
Organization Name:NGA NGUYEN
Other - Org Name:PARK PLACE HEALTH CENTER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PIC
Authorized Official - Prefix:
Authorized Official - First Name:NGA
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-847-6800
Mailing Address - Street 1:9809 ROWLETT RD
Mailing Address - Street 2:STE F
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77075-3403
Mailing Address - Country:US
Mailing Address - Phone:713-847-6800
Mailing Address - Fax:713-847-6801
Practice Address - Street 1:9809 ROWLETT RD
Practice Address - Street 2:STE F
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77075-3403
Practice Address - Country:US
Practice Address - Phone:713-847-6800
Practice Address - Fax:713-847-6801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
TX253163336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2099675OtherPK