Provider Demographics
NPI:1376858456
Name:TRAN, BILLY
Entity Type:Individual
Prefix:
First Name:BILLY
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:637 ROBERT BLVD
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-1647
Mailing Address - Country:US
Mailing Address - Phone:985-288-6300
Mailing Address - Fax:985-288-6293
Practice Address - Street 1:637 ROBERT BLVD
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-1647
Practice Address - Country:US
Practice Address - Phone:985-288-6300
Practice Address - Fax:985-288-6293
Is Sole Proprietor?:No
Enumeration Date:2010-08-12
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA18353183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist