Provider Demographics
NPI:1366770885
Name:NGUYEN, NHATANH HA (PHARM D)
Entity type:Individual
Prefix:DR
First Name:NHATANH
Middle Name:HA
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 S CROWLEY RD
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-3639
Mailing Address - Country:US
Mailing Address - Phone:817-297-1734
Mailing Address - Fax:817-297-1869
Practice Address - Street 1:901 S CROWLEY RD
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-3639
Practice Address - Country:US
Practice Address - Phone:817-297-1734
Practice Address - Fax:817-297-1869
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42775183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist