Provider Demographics
NPI:1467780353
Name:NGUYEN, SOPHIA LY (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:SOPHIA
Middle Name:LY
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10211 SAGECOURT DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-5605
Mailing Address - Country:US
Mailing Address - Phone:281-728-2938
Mailing Address - Fax:
Practice Address - Street 1:16185 SPACE CENTER BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77062-6210
Practice Address - Country:US
Practice Address - Phone:281-486-1872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43495183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist