Healthcare Provider Details

I. General information

NPI: 1518892389
Provider Name (Legal Business Name): MAI TRAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3016 SW 136TH ST
OKLAHOMA CITY OK
73170-5168
US

IV. Provider business mailing address

3016 SW 136TH ST
OKLAHOMA CITY OK
73170-5168
US

V. Phone/Fax

Practice location:
  • Phone: 405-370-5588
  • Fax:
Mailing address:
  • Phone: 405-370-5588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number16239
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: