Provider Demographics
NPI:1093062010
Name:TRAN, THUAN (RPH)
Entity Type:Individual
Prefix:
First Name:THUAN
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 JUNE DR
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:LA
Mailing Address - Zip Code:70094-2915
Mailing Address - Country:US
Mailing Address - Phone:504-430-2043
Mailing Address - Fax:
Practice Address - Street 1:1107 VETERANS MEMORIAL BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-2748
Practice Address - Country:US
Practice Address - Phone:504-837-2516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA019867183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist