Individual provider Active NPI

Alan DT Nguyen

  • Pharmacist
  • Fort Worth, TX
National Provider Identifier
1104437839
Registry record updated Aug 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
57102 Issued in TX
Practice address
3614 Camp Bowie Blvd
Fort Worth, TX 76107-3352
Phone
(817) 870-1873
NPI assigned
Aug 15, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 57102 TX Primary

Addresses

Primary practice location

3614 Camp Bowie Blvd
Fort Worth, TX 76107-3352

Mailing address

2510 Mill Place Rd
Mansfield, TX 76063-4989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597449600000",
    "number": "1104437839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 MILL PLACE RD",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760634989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3614 CAMP BOWIE BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761073352",
            "telephone_number": "817-870-1873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ALAN",
        "middle_name": "DT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-15",
        "last_updated": "2020-08-15",
        "certification_date": "2020-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "57102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.