Provider Demographics
NPI:1457646507
Name:TRAN, YEN KIM LE
Entity Type:Individual
Prefix:
First Name:YEN
Middle Name:KIM LE
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 1:601 S PLANO RD
Mailing Address - Street 2:T-1430
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-4512
Mailing Address - Country:US
Mailing Address - Phone:214-530-0184
Mailing Address - Fax:
Practice Address - Street 1:601 S PLANO RD
Practice Address - Street 2:T-1430
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-4512
Practice Address - Country:US
Practice Address - Phone:214-530-0184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist