MEDICARE: MISS THERESA 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	101YM0800X	Mental Health Counselor	90042	TX

General Provider Information

NPI Number	:	1558985572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS THERESA TRAN

Provider Business Mailing Address
First Line	:	511 S CENTER ST UNIT A
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76010-1712
Country	:	US
Telephone Number	:	817-501-6080
Fax Number	:

Provider Business Practice Location Address
First Line	:	2601 LITTLE ELM PKWY STE 1704
Second Line	:
City	:	LITTLE ELM
State	:	TX
Zip	:	75068-2503
Country	:	US
Telephone Number	:	817-501-6080
Fax Number	:

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

Provider Enumeration Date	:	06/05/2020
Last Update Date	:	07/09/2025

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