Provider Demographics
NPI:1255882387
Name:NGUYEN, DAN TUONG (PHARM D)
Entity type:Individual
Prefix:
First Name:DAN
Middle Name:TUONG
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 1:1200 E BRIN ST
Mailing Address - Street 2:PHARMACY
Mailing Address - City:TERRELL
Mailing Address - State:TX
Mailing Address - Zip Code:75160-2938
Mailing Address - Country:US
Mailing Address - Phone:972-651-8836
Mailing Address - Fax:
Practice Address - Street 1:1200 E BRIN ST
Practice Address - Street 2:PHARMACY
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75160-2938
Practice Address - Country:US
Practice Address - Phone:972-651-8836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX58809183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist