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NPI Code Detail

MEDICARE: DR. DIEM PHUONG NGOC TRAN O.D.

MEDICARE: DR. DIEM PHUONG NGOC TRAN O.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
1152W00000XOptometrist8270TTX

General Provider Information

NPI Number : 1679977797
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DIEM PHUONG NGOC TRAN O.D.
Provider Business Mailing Address
First Line : 8250 PARK PLACE BLVD APT 207
Second Line :
City : HOUSTON
State : TX
Zip : 77017-3125
Country : US
Telephone Number : 713-837-6983
Fax Number :
Provider Business Practice Location Address
First Line : 13615 BELLAIRE BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77083-1714
Country : US
Telephone Number : 281-402-8717
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2014
Last Update Date : 10/17/2014

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