Provider Demographics
NPI:1407619596
Name:NGUYEN, TIEN NGOC (PHARMD)
Entity Type:Individual
Prefix:
First Name:TIEN
Middle Name:NGOC
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 1:11513 CARSON AVE
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7268
Mailing Address - Country:US
Mailing Address - Phone:832-638-3799
Mailing Address - Fax:
Practice Address - Street 1:4746 TWIN CITY HWY
Practice Address - Street 2:
Practice Address - City:GROVES
Practice Address - State:TX
Practice Address - Zip Code:77619-3038
Practice Address - Country:US
Practice Address - Phone:409-960-6394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73417183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist