Provider Demographics
NPI:1376175711
Name:TRUONG, DAN (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:DAN
Middle Name:
Last Name:TRUONG
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 N PRESTON RD
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-9095
Mailing Address - Country:US
Mailing Address - Phone:972-346-5210
Mailing Address - Fax:972-346-5213
Practice Address - Street 1:1250 N PRESTON RD
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-9095
Practice Address - Country:US
Practice Address - Phone:972-346-5210
Practice Address - Fax:972-346-5213
Is Sole Proprietor?:No
Enumeration Date:2020-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX387691835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist