MEDICARE: DR. TINH VAN TRAN M.D.

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	174400000X	Specialist

General Provider Information

NPI Number	:	1386729390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TINH VAN TRAN M.D.

Provider Business Mailing Address
First Line	:	2420 DUNLAVY ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-2404
Country	:	US
Telephone Number	:	713-529-5611
Fax Number	:	713-520-6702

Provider Business Practice Location Address
First Line	:	2420 DUNLAVY ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-2404
Country	:	US
Telephone Number	:	713-529-5611
Fax Number	:	713-520-6702

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

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	07/08/2007

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