Provider Demographics
NPI:1992305536
Name:TRINH, YEN-PHUONG THI (PHARMD)
Entity type:Individual
Prefix:
First Name:YEN-PHUONG
Middle Name:THI
Last Name:TRINH
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 1:1701 N 23RD ST
Mailing Address - Street 2:
Mailing Address - City:CANYON
Mailing Address - State:TX
Mailing Address - Zip Code:79015-7962
Mailing Address - Country:US
Mailing Address - Phone:806-655-2581
Mailing Address - Fax:
Practice Address - Street 1:1701 N 23RD ST
Practice Address - Street 2:
Practice Address - City:CANYON
Practice Address - State:TX
Practice Address - Zip Code:79015-7962
Practice Address - Country:US
Practice Address - Phone:806-655-2581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX49826183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist