Provider Demographics
NPI:1750653424
Name:NGUYEN, KEVIN LINH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:LINH
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 ONEIDA DR
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-2311
Mailing Address - Country:US
Mailing Address - Phone:214-335-2284
Mailing Address - Fax:
Practice Address - Street 1:7164 TECHNOLOGY DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-2094
Practice Address - Country:US
Practice Address - Phone:800-424-9002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-27
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40176183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist