Individual provider Active NPI

Tai The Nguyen, PHARM.D

  • Pharmacist
  • Broken Arrow, OK
National Provider Identifier
1629355185
Registry record updated Nov 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13458 Issued in OK
Practice address
4704 S Elm PL
Broken Arrow, OK 74011-3220
Phone
(918) 455-8308
Fax
(918) 455-1904
NPI assigned
Nov 11, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 13458 OK Primary

Addresses

Primary practice location

4704 S Elm PL
Broken Arrow, OK 74011-3220

Mailing address

4704 S Elm PL
Broken Arrow, OK 74011-3220
Phone (918) 455-8308

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
13458OKMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1320969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320969600000",
    "number": "1629355185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4704 S ELM PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740113220",
            "telephone_number": "918-455-8308",
            "fax_number": "918-455-1904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4704 S ELM PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740113220",
            "telephone_number": "918-455-8308",
            "fax_number": "918-455-1904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TAI",
        "middle_name": "THE",
        "credential": "PHARM.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-11",
        "last_updated": "2011-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "13458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2011; 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.