Healthcare Provider Details

I. General information

NPI: 1578934089
Provider Name (Legal Business Name): TRANG TRAN PHARMD, BCPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2015
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 VETERANS DR
MINNEAPOLIS MN
55417-2309
US

IV. Provider business mailing address

4500 S LANCASTER RD
DALLAS TX
75216-7167
US

V. Phone/Fax

Practice location:
  • Phone: 951-836-7390
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number54873
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: