Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | 13877 | TX |
NPI | 1366916223 |
---|---|
Provider Name | Mechelle Tran |
First Address | Fulshear, TX 77441-1186 |
Second Address | Fulshear, TX 77441-1186 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2019 |
Last Update Date | 14/01/2019 |