Provider Demographics
NPI:1730580945
Name:TRAN, DUONG
Entity type:Individual
Prefix:
First Name:DUONG
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5271 E IDLEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70128-2933
Mailing Address - Country:US
Mailing Address - Phone:504-218-6373
Mailing Address - Fax:
Practice Address - Street 1:4400 S CLAIBORNE AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70125-5106
Practice Address - Country:US
Practice Address - Phone:048-910-9765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-07
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.021248183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist