Provider Demographics
NPI:1417308735
Name:TRAN, DO QUYEN
Entity Type:Individual
Prefix:
First Name:DO QUYEN
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 IH 45 S
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-4903
Mailing Address - Country:US
Mailing Address - Phone:936-999-7001
Mailing Address - Fax:939-999-7002
Practice Address - Street 1:223 IH 45 S
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-4903
Practice Address - Country:US
Practice Address - Phone:936-999-7001
Practice Address - Fax:936-999-7002
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2020-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX58486183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist