Provider Demographics
NPI:1063740413
Name:LE, MYDUNG TRAN (PHARM D)
Entity type:Individual
Prefix:DR
First Name:MYDUNG
Middle Name:TRAN
Last Name:LE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 EAST NASA PARKWAY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058
Mailing Address - Country:US
Mailing Address - Phone:281-990-8024
Mailing Address - Fax:281-486-0185
Practice Address - Street 1:1301 NASA PKWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3112
Practice Address - Country:US
Practice Address - Phone:281-990-8024
Practice Address - Fax:281-486-0185
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-23
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX46564183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist