Provider Demographics
NPI:1245815919
Name:NGUYEN, TUNG DINH (PHARM D)
Entity type:Individual
Prefix:
First Name:TUNG
Middle Name:DINH
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 1:8200 MATLOCK RD STE 150
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-4806
Mailing Address - Country:US
Mailing Address - Phone:682-222-7830
Mailing Address - Fax:682-222-7829
Practice Address - Street 1:8200 MATLOCK RD STE 150
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76002-4806
Practice Address - Country:US
Practice Address - Phone:682-222-7830
Practice Address - Fax:682-222-7829
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42852183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist