Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 21275 | TX |
Y | 213EG0000X | General Practice | 21275 | TX |
NPI | 1003930561 |
---|---|
Provider Name | Ha T Tran |
First Address | Dallas, TX 75227-4930 |
Second Address | Dallas, TX 75227-4930 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 21/05/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
159007702 | (05) | TX |
159007704 | (05) | TX |