Provider Demographics
NPI:1316261407
Name:NGUYEN, NAM QUOC (PHARM D)
Entity type:Individual
Prefix:
First Name:NAM
Middle Name:QUOC
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 1:603 S LOGAN DR APT 2
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-0985
Mailing Address - Country:US
Mailing Address - Phone:713-493-1296
Mailing Address - Fax:
Practice Address - Street 1:1801 S 10TH ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-5401
Practice Address - Country:US
Practice Address - Phone:956-661-1351
Practice Address - Fax:956-661-1132
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41867183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist