Provider Demographics
NPI:1154148880
Name:TRAN, TRANG NGOC PHUONG (PHARMD)
Entity type:Individual
Prefix:
First Name:TRANG
Middle Name:NGOC PHUONG
Last Name:TRAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 N PANTANO RD APT 193
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-1489
Mailing Address - Country:US
Mailing Address - Phone:520-425-9313
Mailing Address - Fax:
Practice Address - Street 1:7150 E SPEEDWAY BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-1318
Practice Address - Country:US
Practice Address - Phone:520-722-8669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-24
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS027240183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist