Provider Demographics
NPI:1942729512
Name:DINH, NGUYET ANH (RPH)
Entity Type:Individual
Prefix:
First Name:NGUYET
Middle Name:ANH
Last Name:DINH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6922 RAVEN MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-3450
Mailing Address - Country:US
Mailing Address - Phone:817-715-9913
Mailing Address - Fax:
Practice Address - Street 1:496 US HIGHWAY 84 E
Practice Address - Street 2:
Practice Address - City:CAIRO
Practice Address - State:GA
Practice Address - Zip Code:39828-1647
Practice Address - Country:US
Practice Address - Phone:229-377-7644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-15
Last Update Date:2017-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH030213183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist