Provider Demographics
NPI:1316546617
Name:TRAN, COURTNEY (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:
Last Name:TRAN
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 1:4820 APPLERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-3853
Mailing Address - Country:US
Mailing Address - Phone:469-569-5960
Mailing Address - Fax:
Practice Address - Street 1:4017 14TH ST
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-7113
Practice Address - Country:US
Practice Address - Phone:972-424-7529
Practice Address - Fax:972-422-0278
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX416511835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist