Provider Demographics
NPI:1861093130
Name:TRAN, JENNIFER ANHTHU (PHARMD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANHTHU
Last Name:TRAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:THU
Other - Middle Name:ANH
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1821 MCCLARY ST
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-4399
Mailing Address - Country:US
Mailing Address - Phone:469-682-0423
Mailing Address - Fax:
Practice Address - Street 1:101 W BUCKINGHAM RD
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-4646
Practice Address - Country:US
Practice Address - Phone:469-304-3427
Practice Address - Fax:469-304-3403
Is Sole Proprietor?:No
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45418183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist