Provider Demographics
NPI:1184065252
Name:NGUYEN, THUCVU THANH (RPH)
Entity type:Individual
Prefix:
First Name:THUCVU
Middle Name:THANH
Last Name:NGUYEN
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 1:812 WINDSOR HILL DR
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-8058
Mailing Address - Country:US
Mailing Address - Phone:512-251-7670
Mailing Address - Fax:
Practice Address - Street 1:1000 E CENTRAL TEXAS EXPY
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-9162
Practice Address - Country:US
Practice Address - Phone:254-526-4258
Practice Address - Fax:254-526-8809
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39535183500000X
OH03224836183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist