Provider Demographics
NPI:1992344840
Name:NGUYEN, ANHTHU LE (PHARMD)
Entity type:Individual
Prefix:
First Name:ANHTHU
Middle Name:LE
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 1:5591 BEVERLYHILL ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-6801
Mailing Address - Country:US
Mailing Address - Phone:832-606-4658
Mailing Address - Fax:
Practice Address - Street 1:1615 INTERSTATE 10 S
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4759
Practice Address - Country:US
Practice Address - Phone:409-840-9776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-24
Last Update Date:2019-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66033183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist