Healthcare Provider Details
I. General information
NPI: 1548240799
Provider Name (Legal Business Name): LOANN T TRINH D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/21/2006
Last Update Date: 02/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8557 RESEARCH BLVD SUITE # 128
AUSTIN TX
78758-7856
US
IV. Provider business mailing address
8557 RESEARCH BLVD STE 128
AUSTIN TX
78758-7855
US
V. Phone/Fax
- Phone: 512-836-7399
- Fax: 512-836-7378
- Phone: 512-836-7399
- Fax: 512-836-7378
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | L1765 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QS0010X |
| Taxonomy | Sports Medicine (Family Medicine) Physician |
| License Number | L1765 |
| License Number State | TX |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | L1765 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: