Provider Demographics
NPI:1407475684
Name:PCN CARE PLLC
Entity Type:Organization
Organization Name:PCN CARE PLLC
Other - Org Name:MD KIDS PEDIATRIC'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:DUC
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:469-206-6116
Mailing Address - Street 1:3108 WILLOW BROOK DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-2075
Mailing Address - Country:US
Mailing Address - Phone:682-367-9018
Mailing Address - Fax:
Practice Address - Street 1:3201 W SANER AVE STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75233-1430
Practice Address - Country:US
Practice Address - Phone:214-377-4310
Practice Address - Fax:214-331-7630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-08
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy