Individual
THAO TRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5017 PALO DURO AVE NE, ALBUQUERQUE, NM 87110-1113
(505) 750-2105
Mailing address
5017 PALO DURO AVE NE, ALBUQUERQUE, NM 87110-1113
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
IN00003492
NM
Other
Enumeration date
01/21/2014
Last updated
01/21/2014
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