Provider Demographics
NPI:1285356584
Name:TRAN, QUYEN ANH
Entity type:Individual
Prefix:
First Name:QUYEN
Middle Name:ANH
Last Name:TRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 MISTY MESA TRL # 2
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-4854
Mailing Address - Country:US
Mailing Address - Phone:817-682-1221
Mailing Address - Fax:
Practice Address - Street 1:6220 US 287 HWY
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76001-2800
Practice Address - Country:US
Practice Address - Phone:817-478-1313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy