Provider Demographics
NPI:1922600097
Name:VU, NGUYET (RPH)
Entity Type:Individual
Prefix:
First Name:NGUYET
Middle Name:
Last Name:VU
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:NIKKI
Other - Middle Name:
Other - Last Name:VU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2625 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-1813
Mailing Address - Country:US
Mailing Address - Phone:713-261-5386
Mailing Address - Fax:
Practice Address - Street 1:2625 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-1813
Practice Address - Country:US
Practice Address - Phone:281-724-6749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50605183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist