Healthcare Provider Details

I. General information

NPI: 1114754082
Provider Name (Legal Business Name): STEVEN TRAN DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2024
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 N TENAYA WAY STE 180
LAS VEGAS NV
89128-1110
US

IV. Provider business mailing address

2650 N TENAYA WAY STE 180
LAS VEGAS NV
89128-1110
US

V. Phone/Fax

Practice location:
  • Phone: 702-240-2952
  • Fax:
Mailing address:
  • Phone: 702-240-2952
  • Fax: 702-243-0482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6542
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: