Provider Demographics
NPI:1942923636
Name:TRAN, GIANG KHANH
Entity Type:Individual
Prefix:
First Name:GIANG
Middle Name:KHANH
Last Name:TRAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3990 E LUCAS DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77708-5513
Mailing Address - Country:US
Mailing Address - Phone:409-898-2990
Mailing Address - Fax:409-898-3471
Practice Address - Street 1:3990 E LUCAS DR
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77708-5513
Practice Address - Country:US
Practice Address - Phone:409-898-2990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71347183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist