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NPI Code Detail

MEDICARE: DR. LARRY TRAN MD

MEDICARE:  DR. LARRY  TRAN  MD
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
12084N0400XNeurology PhysicianP0312TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P01392341OTHERTXRR MEDICARE
4P01142222OTHERTXRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18DF382OTHERTXBLUE CROSS BLUE SHIELD
31629259510OTHERTXBLUE CROSS BLUE SHIELD
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629259510
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LARRY TRAN MD
Provider Business Mailing Address
First Line : 16537 SOUTHWEST FWY STE 500
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-7244
Country : US
Telephone Number : 281-274-7595
Fax Number : 281-494-6410
Provider Business Practice Location Address
First Line : 16537 SOUTHWEST FWY STE 500
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-7244
Country : US
Telephone Number : 812-747-5952
Fax Number : 281-494-6410
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2007
Last Update Date : 06/24/2024

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