MEDICARE: KELLY TRAN PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	61576	TX

General Provider Information

NPI Number	:	1427661727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY TRAN PHARMD

Provider Business Mailing Address
First Line	:	3214 MONTROSE SUITE 120
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006
Country	:	US
Telephone Number	:	713-258-1582
Fax Number	:	713-258-1583

Provider Business Practice Location Address
First Line	:	3217 MONTROSE BLVD STE 120
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-3944
Country	:	US
Telephone Number	:	713-258-1582
Fax Number	:	713-258-1583

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2020
Last Update Date	:	08/26/2020

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Directions to “ KELLY TRAN PHARMD” Practice Location

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