Provider Demographics
NPI:1295144194
Name:NGUYEN, CARRIE ANH (RPH)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANH
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 1:6628 PALERMO TRL
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75077-8500
Mailing Address - Country:US
Mailing Address - Phone:972-467-2070
Mailing Address - Fax:
Practice Address - Street 1:3980 STATE SCHOOL RD
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-8823
Practice Address - Country:US
Practice Address - Phone:940-591-3208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37592183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist