Provider Demographics
NPI:1275869844
Name:NGUYEN, VAN HOANG (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:VAN
Middle Name:HOANG
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 1:910 CRESTED COVE DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-3486
Mailing Address - Country:US
Mailing Address - Phone:469-682-0926
Mailing Address - Fax:
Practice Address - Street 1:5434 HIGHWAY 78
Practice Address - Street 2:
Practice Address - City:SACHSE
Practice Address - State:TX
Practice Address - Zip Code:75048-3740
Practice Address - Country:US
Practice Address - Phone:972-495-0408
Practice Address - Fax:972-530-5791
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-02
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43515183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist