Healthcare Provider Details

I. General information

NPI: 1144746470
Provider Name (Legal Business Name): VU TRAN OD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2017
Last Update Date: 09/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4040 N MACARTHUR BLVD SUITE 102
IRVING TX
75038
US

IV. Provider business mailing address

3207 HYDE ST
IRVING TX
75063-0159
US

V. Phone/Fax

Practice location:
  • Phone: 469-607-3937
  • Fax: 469-607-3957
Mailing address:
  • Phone: 469-607-3937
  • Fax: 469-607-3957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: VU TRAN
Title or Position: OWNER/PRESIDENT
Credential: O.D.
Phone: 218-864-9652