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General NPI Number Information
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NPI Number | 1144954686
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Entity Type | Individual
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Provider Name | THOMAS TRAN PHARM D
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Gender | Male
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Dates
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Enumeration Date | 07/11/2022
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Last Update Date | 07/11/2022
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Provider Practice Location Address
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Address Line | 3425 53RD AVE W
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City | BRADENTON
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State | FL
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Zip | 34210-3490
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Country | US
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Telephone | 941-752-7997
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Fax |
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Provider Business Mailing Address
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Address Line | 4300 18TH ST W APT D302
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City | BRADENTON
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State | FL
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Zip | 34205-9143
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Country | US
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Telephone | 714-622-8061
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS64155
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License Number State | FL
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