Provider Demographics
NPI:1346553369
Name:TRAN, KATHRYN T (RPH)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:T
Last Name:TRAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 TURNER RIDGE DR
Mailing Address - Street 2:APT #9306
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76110-7436
Mailing Address - Country:US
Mailing Address - Phone:806-206-5677
Mailing Address - Fax:
Practice Address - Street 1:1810 TURNER RIDGE DR
Practice Address - Street 2:APT #9306
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76110-7436
Practice Address - Country:US
Practice Address - Phone:806-206-5677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-19
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX48095183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist