Provider Demographics
NPI:1245815919
Name:NGUYEN, TUNG DINH (PHARM D)
Entity type:Individual
Prefix:
First Name:TUNG
Middle Name:DINH
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 1:1410 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EASTLAND
Mailing Address - State:TX
Mailing Address - Zip Code:76448-3023
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1410 E MAIN ST
Practice Address - Street 2:
Practice Address - City:EASTLAND
Practice Address - State:TX
Practice Address - Zip Code:76448-3023
Practice Address - Country:US
Practice Address - Phone:254-629-3347
Practice Address - Fax:254-629-2061
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-15
Last Update Date:2025-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42852183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist