Provider Demographics
NPI:1437924578
Name:DANG, TUAN QUOC
Entity Type:Individual
Prefix:
First Name:TUAN
Middle Name:QUOC
Last Name:DANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6383 WHITE HERON CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-7234
Mailing Address - Country:US
Mailing Address - Phone:702-666-1956
Mailing Address - Fax:
Practice Address - Street 1:6383 WHITE HERON CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89139-7234
Practice Address - Country:US
Practice Address - Phone:702-666-1956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV16238183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist