Provider Demographics
NPI:1437275120
Name:TRAN, THAO THANH-THI (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:THAO
Middle Name:THANH-THI
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 1:101 WEST BROAD STREET
Mailing Address - Street 2:GEORGE MASON SQUARE ANNEX, 3RD FLOOR
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046
Mailing Address - Country:US
Mailing Address - Phone:703-531-2420
Mailing Address - Fax:703-531-2437
Practice Address - Street 1:1718 ASPENWOOD DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3061
Practice Address - Country:US
Practice Address - Phone:757-508-7858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202206629183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist