MEDICARE: MY LINH 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	64006	TX

General Provider Information

NPI Number	:	1689265795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MY LINH TRAN PHARMD

Provider Business Mailing Address
First Line	:	2421 SAM HOUSTON AVE
Second Line	:
City	:	HUNTSVILLE
State	:	TX
Zip	:	77340-5862
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2421 SAM HOUSTON AVE
Second Line	:
City	:	HUNTSVILLE
State	:	TX
Zip	:	77340-5862
Country	:	US
Telephone Number	:	936-439-9038
Fax Number	:

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

Provider Enumeration Date	:	02/01/2021
Last Update Date	:	02/01/2021

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Directions to “ MY LINH TRAN PHARMD” Practice Location

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