Provider Demographics
NPI:1013634518
Name:CAO, BRIAN THIEN SINH (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:THIEN SINH
Last Name:CAO
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 1:1121 NATCHEZ PT APT 99
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-0979
Mailing Address - Country:US
Mailing Address - Phone:860-869-9196
Mailing Address - Fax:
Practice Address - Street 1:8046 MACON RD
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-8531
Practice Address - Country:US
Practice Address - Phone:901-753-1331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-25
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN46351183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist