Individual
DR. BRIAN TIEU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
80B VETERANS BLVD, ACOMA, NM 87034
(505) 552-5457
(505) 552-5464
Mailing address
PO BOX 130, SAN FIDEL, NM 87049-0130
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
65284
CA
183500000X
Pharmacist
PH-3136
HI
Other
Enumeration date
09/26/2011
Last updated
03/15/2012
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