Provider Demographics
NPI:1629072616
Name:NGUYEN, YOUNG THI-MY
Entity Type:Individual
Prefix:MRS
First Name:YOUNG
Middle Name:THI-MY
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 THORNE HILL CT
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-3763
Mailing Address - Country:US
Mailing Address - Phone:972-889-0241
Mailing Address - Fax:
Practice Address - Street 1:1300 E CAMPBELL RD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-1937
Practice Address - Country:US
Practice Address - Phone:972-792-5228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34842183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX34842OtherPHARMACY LICENSE