Provider Demographics
NPI:1154913556
Name:NGUYEN, AUDREY DAO ANH (PHARMD)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:DAO ANH
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22111 ASH GREEN DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-6416
Mailing Address - Country:US
Mailing Address - Phone:281-301-4050
Mailing Address - Fax:
Practice Address - Street 1:25901 HIGHWAY 290
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-1099
Practice Address - Country:US
Practice Address - Phone:281-256-8102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-07
Last Update Date:2021-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX58465183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist