Provider Demographics
NPI:1558841478
Name:NGUYEN, MINH-DUNG THI (PHARMD)
Entity Type:Individual
Prefix:
First Name:MINH-DUNG
Middle Name:THI
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 1:6741 OLD SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-5513
Mailing Address - Country:US
Mailing Address - Phone:469-471-8889
Mailing Address - Fax:
Practice Address - Street 1:10651 E ST BLDG 100
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78419-5130
Practice Address - Country:US
Practice Address - Phone:361-961-2260
Practice Address - Fax:361-961-3830
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-20
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX474391835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care