Provider Demographics
NPI:1376152918
Name:NGUYEN, VICTORIA PHUONGMAI
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:PHUONGMAI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9330 JONES RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-4408
Mailing Address - Country:US
Mailing Address - Phone:281-894-4859
Mailing Address - Fax:
Practice Address - Street 1:9330 JONES RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4408
Practice Address - Country:US
Practice Address - Phone:281-894-4859
Practice Address - Fax:281-894-5041
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-29
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX355271835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist