Healthcare Provider Details

I. General information

NPI: 1922338680
Provider Name (Legal Business Name): JULIA TRANG RPH, PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/31/2009
Last Update Date: 06/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 BERGQUIST DR
LACKLAND A F B TX
78236
US

IV. Provider business mailing address

1100 WILFORD HALL LOOP BLDG 4554 ATTN: 59 MDW/SGHC
JBSA LACKLAND TX
78236-9908
US

V. Phone/Fax

Practice location:
  • Phone: 210-929-5414
  • Fax: 210-292-5419
Mailing address:
  • Phone: 210-292-3870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number49550
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP043940L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: