MEDICARE: ERICA TRAN

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	224Z00000X	Occupational Therapy Assistant	207875	TX

General Provider Information

NPI Number	:	1184246928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA TRAN

Provider Business Mailing Address
First Line	:	104 E HERITAGE DR
Second Line	:
City	:	FRIENDSWOOD
State	:	TX
Zip	:	77546-3854
Country	:	US
Telephone Number	:	281-993-2009
Fax Number	:	281-993-2007

Provider Business Practice Location Address
First Line	:	4723 WILBURY HEIGHTS DR
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77505-3824
Country	:	US
Telephone Number	:	832-964-9481
Fax Number	:

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

Provider Enumeration Date	:	05/14/2020
Last Update Date	:	05/14/2020

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Directions to “ ERICA TRAN ” Practice Location

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