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General NPI Number Information
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NPI Number | 1285356584
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Entity Type | Individual
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Provider Name | QUYEN ANH TRAN
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Gender | Female
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Dates
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Enumeration Date | 09/13/2022
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Last Update Date | 09/13/2022
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Provider Practice Location Address
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Address Line | 6220 US 287 HWY
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City | ARLINGTON
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State | TX
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Zip | 76001-2800
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Country | US
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Telephone | 817-478-1313
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Fax |
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Provider Business Mailing Address
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Address Line | 64 MISTY MESA TRL # 2
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City | MANSFIELD
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State | TX
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Zip | 76063-4854
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Country | US
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Telephone | 817-682-1221
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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