Provider Demographics
NPI:1831426188
Name:TRAN, HAN NGOC (PHARMD)
Entity type:Individual
Prefix:MS
First Name:HAN
Middle Name:NGOC
Last Name:TRAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MS
Other - First Name:FAVIN
Other - Middle Name:NGOC-HAN
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4121 HARWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-4021
Mailing Address - Country:US
Mailing Address - Phone:817-571-6995
Mailing Address - Fax:817-571-8583
Practice Address - Street 1:4121 HARWOOD RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-5235
Practice Address - Country:US
Practice Address - Phone:817-571-6995
Practice Address - Fax:817-571-8583
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-06
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX46917183500000X
FLPS36489183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist