Provider Demographics
NPI:1457006314
Name:NGUYEN, THIEN KIM V
Entity Type:Individual
Prefix:
First Name:THIEN KIM
Middle Name:V
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 1:7110 STILL HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-7129
Mailing Address - Country:US
Mailing Address - Phone:281-818-4614
Mailing Address - Fax:
Practice Address - Street 1:7110 STILL HAVEN DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-7129
Practice Address - Country:US
Practice Address - Phone:281-818-4614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70075183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist