Provider Demographics
NPI:1083460513
Name:NGUYEN, THUY DIEM QUOC
Entity type:Individual
Prefix:
First Name:THUY DIEM
Middle Name:QUOC
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14706 BAINBROOK LN
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-3429
Mailing Address - Country:US
Mailing Address - Phone:713-478-1641
Mailing Address - Fax:
Practice Address - Street 1:12097 VETERANS MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77067-1001
Practice Address - Country:US
Practice Address - Phone:281-444-6304
Practice Address - Fax:281-444-1390
Is Sole Proprietor?:No
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37625183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist