Provider Demographics
NPI:1831461961
Name:TRAN, TRUC-QUYEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:TRUC-QUYEN
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11120 LOMAS BLVD NE
Mailing Address - Street 2:TARGET #0357
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-5582
Mailing Address - Country:US
Mailing Address - Phone:505-346-0193
Mailing Address - Fax:
Practice Address - Street 1:11120 LOMAS BLVD NE
Practice Address - Street 2:TARGET #0357
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-5582
Practice Address - Country:US
Practice Address - Phone:505-346-0193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM00007501183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist