MEDICARE: ANDY TRAN D.D.S

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	122300000X	Dentist	27961	TX

General Provider Information

NPI Number	:	1598029621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDY TRAN D.D.S

Provider Business Mailing Address
First Line	:	7700 HIGHWAY 6 N
Second Line	:	SUITE 106
City	:	HOUSTON
State	:	TX
Zip	:	77095-2668
Country	:	US
Telephone Number	:	281-550-5757
Fax Number	:

Provider Business Practice Location Address
First Line	:	7700 HIGHWAY 6 N
Second Line	:	SUITE 106
City	:	HOUSTON
State	:	TX
Zip	:	77095-2668
Country	:	US
Telephone Number	:	281-550-5757
Fax Number	:

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

Provider Enumeration Date	:	07/03/2012
Last Update Date	:	11/05/2013

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