Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 06627TG | TX |
NPI | 1003055716 |
---|---|
Provider Name | Mrs. Tuyen Phuong Tran |
First Address | Houston, TX 77089-2583 |
Second Address | Houston, TX 77075-2414 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2009 |
Last Update Date | 17/09/2009 |