MEDICARE: ALICE TRAN PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	PA14521	TX

General Provider Information

NPI Number	:	1134792898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICE TRAN PA-C

Provider Business Mailing Address
First Line	:	8512 KENNING CT
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-7301
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 TALON DR STE 100
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75082-9720
Country	:	US
Telephone Number	:	214-431-4539
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2021
Last Update Date	:	07/21/2021

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Directions to “ ALICE TRAN PA-C” Practice Location

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