Basic Information
| Provider Information | |||||||||
| NPI: | 1003145434 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NGUYEN | ||||||||
| FirstName: | JEANMARC | ||||||||
| MiddleName: | V | ||||||||
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| Credential: | PHARM.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2710 TAYLORCREST | ||||||||
| Address2: | |||||||||
| City: | MISSOURI CITY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774596929 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3246688158 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 9460 W SAM HOUSTON PKWY S | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770991850 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2815683134 | ||||||||
| FaxNumber: | 2815686974 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2009 | ||||||||
| LastUpdateDate: | 11/09/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 44925 | TX | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.