Provider Demographics
NPI:1679346217
Name:NGUYEN, VAN BINH TRAN
Entity Type:Individual
Prefix:
First Name:VAN BINH
Middle Name:TRAN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13711 MISTY BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77085-1323
Mailing Address - Country:US
Mailing Address - Phone:281-617-8776
Mailing Address - Fax:
Practice Address - Street 1:2900 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-4507
Practice Address - Country:US
Practice Address - Phone:281-997-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73077183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist