Provider Demographics
NPI:1619572567
Name:NGUYEN, YEN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:YEN
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
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 1:17323 E SUMMER ROSE CT
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-6723
Mailing Address - Country:US
Mailing Address - Phone:225-802-3742
Mailing Address - Fax:
Practice Address - Street 1:16155 SPRING CYPRESS RD
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-1717
Practice Address - Country:US
Practice Address - Phone:281-256-3070
Practice Address - Fax:281-256-9212
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX46644183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1689771180Medicaid