Provider Demographics
NPI:1275861155
Name:TRAN, NGOAN THERESA (PHARMD)
Entity Type:Individual
Prefix:
First Name:NGOAN
Middle Name:THERESA
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 1:8300 WILCREST DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-4326
Mailing Address - Country:US
Mailing Address - Phone:281-530-6210
Mailing Address - Fax:
Practice Address - Street 1:8300 WILCREST DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-4326
Practice Address - Country:US
Practice Address - Phone:281-530-6210
Practice Address - Fax:281-530-6058
Is Sole Proprietor?:No
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41470183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist