Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | K5719 | TX |
N | 207QG0300X | Family Doctor - Geriatric Medicine | K5719 | TX |
NPI | 1114995305 |
---|---|
Provider Name | Dr. Thuc-Nguyen Vu Tran |
First Address | Frisco, TX 75034-6310 |
Second Address | Carrollton, TX 75010-6537 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 07/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H12263 | (02) | TX |
K5719 | LICENSE (01) | TX |