Individual provider Active NPI

Bao-Tram Le Tran

  • Pharmacist
  • Killeen, TX
National Provider Identifier
1770218612
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
67964 Issued in TX
Practice address
3300 W Stan Schlueter Loop
Killeen, TX 76549-6667
Phone
(214) 603-0485
Fax
(254) 526-4562
NPI assigned
Jul 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 67964 TX Primary

Addresses

Primary practice location

3300 W Stan Schlueter Loop
Killeen, TX 76549-6667

Mailing address

3300 W Stan Schlueter Loop
Killeen, TX 76549-6667

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
67964TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
CVS Pharmacy Inc PastSince Jul 24, 2022 Accepting new patients
CVS Pharmacy Inc PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1658448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1770218612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 W STAN SCHLUETER LOOP",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765496667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 W STAN SCHLUETER LOOP",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765496667",
            "telephone_number": "214-603-0485",
            "fax_number": "254-526-4562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "BAO-TRAM",
        "middle_name": "LE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-22",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "67964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Killeen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.