Provider Demographics
NPI:1619205747
Name:NGUYEN, KHA (PHARM D)
Entity Type:Individual
Prefix:
First Name:KHA
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
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 1:4007 BARKER CYPRESS RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-6802
Mailing Address - Country:US
Mailing Address - Phone:281-550-9804
Mailing Address - Fax:
Practice Address - Street 1:4007 BARKER CYPRESS RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-6802
Practice Address - Country:US
Practice Address - Phone:281-550-9804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-01
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47820183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist