Provider Demographics
NPI:1508419896
Name:TIEU, ARNOLD (PHARMD)
Entity Type:Individual
Prefix:
First Name:ARNOLD
Middle Name:
Last Name:TIEU
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 NE ALSBURY BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-2641
Mailing Address - Country:US
Mailing Address - Phone:682-628-8111
Mailing Address - Fax:682-206-0211
Practice Address - Street 1:780 NE ALSBURY BLVD STE B
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-2641
Practice Address - Country:US
Practice Address - Phone:682-628-8111
Practice Address - Fax:682-206-0211
Is Sole Proprietor?:No
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX490301835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist