Provider Demographics
NPI:1811534993
Name:DINH, NGOC QUANG (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NGOC
Middle Name:QUANG
Last Name:DINH
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 1:2827 TERROSA RD
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75054-0075
Mailing Address - Country:US
Mailing Address - Phone:469-619-7495
Mailing Address - Fax:
Practice Address - Street 1:2827 TERROSA RD
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75054-0075
Practice Address - Country:US
Practice Address - Phone:469-619-7495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-07
Last Update Date:2019-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX56668183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty