Provider Demographics
NPI:1497187728
Name:NGUYEN, JACQUELINE TUYET NHI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:TUYET NHI
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 1:2828 LEMMON AVE EAST
Mailing Address - Street 2:#2109
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-3723
Mailing Address - Country:US
Mailing Address - Phone:832-287-4029
Mailing Address - Fax:
Practice Address - Street 1:6611 N BELT LINE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-6001
Practice Address - Country:US
Practice Address - Phone:972-822-2389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-09
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11876162183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist