Provider Demographics
NPI:1215567516
Name:NGUYEN, SAMANTHA LAM (PHARMD)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:LAM
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 1:3939 FRANKFORD RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-6318
Mailing Address - Country:US
Mailing Address - Phone:972-662-1011
Mailing Address - Fax:972-662-1015
Practice Address - Street 1:3939 FRANKFORD RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-6318
Practice Address - Country:US
Practice Address - Phone:972-662-1011
Practice Address - Fax:972-662-1015
Is Sole Proprietor?:No
Enumeration Date:2020-01-25
Last Update Date:2020-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX444081835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist