Healthcare Provider Details

I. General information

NPI: 1871391482
Provider Name (Legal Business Name): AMY TRAN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2025
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8800 US HIGHWAY 380 STE 100
CROSS ROADS TX
76227-2515
US

IV. Provider business mailing address

3301 SUNDOWN BLVD
DENTON TX
76210-8032
US

V. Phone/Fax

Practice location:
  • Phone: 940-365-9200
  • Fax:
Mailing address:
  • Phone: 940-387-3700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1406287
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: