Provider Demographics
NPI:1689901464
Name:NGUYEN, GINA Q (PHARM D)
Entity Type:Individual
Prefix:MS
First Name:GINA
Middle Name:Q
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 1:1705 COIT RD APT 2037
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-6153
Mailing Address - Country:US
Mailing Address - Phone:918-853-2016
Mailing Address - Fax:
Practice Address - Street 1:3435 LAKEVIEW PKWY
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-3368
Practice Address - Country:US
Practice Address - Phone:972-463-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47231183500000X
KY013819183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist