Provider Demographics
NPI:1740895838
Name:NGUYEN, DENNIS (PHARMD)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:NGUYEN
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 1:13108 OVERLOOK VIEW TRL APT 1528
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76177-2016
Mailing Address - Country:US
Mailing Address - Phone:713-894-9925
Mailing Address - Fax:
Practice Address - Street 1:201 GOLDEN TRIANGLE BLVD
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-4484
Practice Address - Country:US
Practice Address - Phone:817-898-6164
Practice Address - Fax:817-898-6163
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66476183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist