Provider Demographics
NPI:1609127315
Name:NGUYEN, QUYEN HOANG (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:QUYEN
Middle Name:HOANG
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2430 NORTH FRY ROAD #104
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-5831
Mailing Address - Country:US
Mailing Address - Phone:281-579-1310
Mailing Address - Fax:281-579-3385
Practice Address - Street 1:2430 NORTH FRY ROAD #104
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-5831
Practice Address - Country:US
Practice Address - Phone:281-579-1310
Practice Address - Fax:281-579-3385
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-21
Last Update Date:2021-01-18
Deactivation Date:2017-04-05
Deactivation Code:
Reactivation Date:2021-01-18
Provider Licenses
StateLicense IDTaxonomies
TX38895183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist