Individual
DAT TRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
6200 W WILLIAM CANNON DR, AUSTIN, TX 78749-1794
(512) 892-1933
(512) 892-0765
Mailing address
6200 W WILLIAM CANNON DR, AUSTIN, TX 78749-1794
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
71423
TX
Other
Enumeration date
11/28/2022
Last updated
11/28/2022
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