Provider Demographics
NPI:1750838611
Name:NGUYEN, CHRISTOPHER THY ANH (PHARM D)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:THY ANH
Last Name:NGUYEN
Suffix:
Gender:M
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 1:115 MIDLAND DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-5011
Mailing Address - Country:US
Mailing Address - Phone:337-322-6350
Mailing Address - Fax:
Practice Address - Street 1:1229 NW EVANGELINE TRWY
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501-3551
Practice Address - Country:US
Practice Address - Phone:337-232-1031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.021613183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist