Provider Demographics
NPI:1700479276
Name:DINH, NGUYEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:NGUYEN
Middle Name:
Last Name:DINH
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 1:2216 PALMER TRL
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-1960
Mailing Address - Country:US
Mailing Address - Phone:469-438-0734
Mailing Address - Fax:
Practice Address - Street 1:3950 S CARRIER PKWY STE 100
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-6671
Practice Address - Country:US
Practice Address - Phone:469-909-4093
Practice Address - Fax:469-909-4094
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47767183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist