Provider Demographics
NPI:1760918841
Name:TRAN, CHAD QUANG (RPH)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:QUANG
Last Name:TRAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 ACADEMY DR
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-1606
Mailing Address - Country:US
Mailing Address - Phone:504-327-9001
Mailing Address - Fax:
Practice Address - Street 1:3300 ACADEMY DR
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70003-1606
Practice Address - Country:US
Practice Address - Phone:504-327-9001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-10
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA021926183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist