Provider Demographics
NPI:1679856504
Name:DINH, THOMAS TIEN (RPH)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:TIEN
Last Name:DINH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1663 N SAGEBRUSH ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67230-7010
Mailing Address - Country:US
Mailing Address - Phone:316-733-9580
Mailing Address - Fax:
Practice Address - Street 1:1663 N SAGEBRUSH ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67230-7010
Practice Address - Country:US
Practice Address - Phone:316-733-9580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11145183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist