Provider Demographics
NPI:1831738343
Name:NGUYEN, TUYEN (PHD)
Entity type:Individual
Prefix:
First Name:TUYEN
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1632 S FALCON DR
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-5800
Mailing Address - Country:US
Mailing Address - Phone:408-637-9928
Mailing Address - Fax:
Practice Address - Street 1:4040 N 19TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-5303
Practice Address - Country:US
Practice Address - Phone:602-265-3167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-31
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS024244183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist