Provider Demographics
NPI:1013434018
Name:TRAN, ANH THI PHUONG
Entity Type:Individual
Prefix:
First Name:ANH
Middle Name:THI PHUONG
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 1:437 SADDLEBROOK CT
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70435-0530
Mailing Address - Country:US
Mailing Address - Phone:504-430-2213
Mailing Address - Fax:
Practice Address - Street 1:437 SADDLEBROOK CT
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70435-0530
Practice Address - Country:US
Practice Address - Phone:504-430-2213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.022162183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist