Provider Demographics
NPI:1871900928
Name:TRAN, THU YEN THI (MBA, PHARMD)
Entity type:Individual
Prefix:
First Name:THU YEN
Middle Name:THI
Last Name:TRAN
Suffix:
Gender:F
Credentials:MBA, PHARMD
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MBA, PHARMD
Mailing Address - Street 1:12617 W ARIZONA PL
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-3557
Mailing Address - Country:US
Mailing Address - Phone:720-934-8074
Mailing Address - Fax:
Practice Address - Street 1:16601 E CENTRETECH PKWY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-9045
Practice Address - Country:US
Practice Address - Phone:303-739-3668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20319183500000X
NV18672183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist