MEDICARE: KIM 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	207Q00000X	Family Medicine Physician	K4818	TX

General Provider Information

NPI Number	:	1609877208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIM TRAN M.D.

Provider Business Mailing Address
First Line	:	6053 MAIN ST STE 130
Second Line	:
City	:	THE COLONY
State	:	TX
Zip	:	75056-4706
Country	:	US
Telephone Number	:	972-625-7000
Fax Number	:	972-625-8787

Provider Business Practice Location Address
First Line	:	6053 MAIN ST STE 130
Second Line	:
City	:	THE COLONY
State	:	TX
Zip	:	75056-4706
Country	:	US
Telephone Number	:	972-625-7000
Fax Number	:	972-625-8787

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

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	06/13/2019

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