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NPI Code Detail

MEDICARE: CASEY TRAN D.O.

MEDICARE:   CASEY  TRAN  D.O.
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207Q00000XFamily Medicine PhysicianR0799TX

General Provider Information

NPI Number : 1457746158
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASEY TRAN D.O.
Provider Business Mailing Address
First Line : 1200 W WALNUT HILL LN STE 1300
Second Line :
City : IRVING
State : TX
Zip : 75038-3050
Country : US
Telephone Number : 817-446-0800
Fax Number :
Provider Business Practice Location Address
First Line : 6302 MEADOWBROOK DR STE 112
Second Line :
City : FORT WORTH
State : TX
Zip : 76112-5163
Country : US
Telephone Number : 817-446-0800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2015
Last Update Date : 09/20/2024

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Directions to “ CASEY TRAN D.O.” Practice Location

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