Healthcare Provider Details

I. General information

NPI: 1043453335
Provider Name (Legal Business Name): VICTOR Q TRAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: VICTOR QUOC-VI TRAN M.D.

II. Dates (important events)

Enumeration Date: 04/15/2009
Last Update Date: 01/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8888 SUMMA AVE CARDIOLOGY TOWER 3RD FLOOR
BATON ROUGE LA
70809-3720
US

IV. Provider business mailing address

8888 SUMMA AVE CARDIOLOGY TOWER 3RD FLOOR
BATON ROUGE LA
70809-3720
US

V. Phone/Fax

Practice location:
  • Phone: 225-769-4493
  • Fax: 225-766-3144
Mailing address:
  • Phone: 225-769-4493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMD.202830
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: