Organization
MTN CORPORATION
Active
Other names
TN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
PHUONG HUU NGUYEN PHARMACIST (PIC)
(281) 561-0101
Entity
Organization
Contact information
Practice address
12989 BELLAIRE BLVD, STE 1A, HOUSTON, TX 77072-5133
(281) 561-0101
(281) 561-0333
Mailing address
12989 BELLAIRE BLVD, STE 1A, HOUSTON, TX 77072-5133
(281) 561-0101
(281) 561-0333
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
16702
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144298
—
TX
01
—
2100811
PK
—
Enumeration date
06/20/2006
Last updated
05/08/2021
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