Provider Demographics
NPI:1346921038
Name:NGUYEN, QUOC TRIEU (PHARMD)
Entity Type:Individual
Prefix:
First Name:QUOC
Middle Name:TRIEU
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9200 TOWN SQUARE BLVD APT 3211
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-1300
Mailing Address - Country:US
Mailing Address - Phone:469-407-8991
Mailing Address - Fax:
Practice Address - Street 1:300 W 15TH ST
Practice Address - Street 2:
Practice Address - City:HEREFORD
Practice Address - State:TX
Practice Address - Zip Code:79045-3051
Practice Address - Country:US
Practice Address - Phone:806-364-4459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72448183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist