Healthcare Provider Details
I. General information
NPI: 1285453357
Provider Name (Legal Business Name): VICTORIA TRAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/07/2024
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1635 S FRY RD
KATY TX
77450-6404
US
IV. Provider business mailing address
7500 SAN FELIPE ST STE 990
HOUSTON TX
77063-1708
US
V. Phone/Fax
- Phone: 281-616-8075
- Fax:
- Phone: 866-610-0580
- Fax: 866-611-1558
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106E00000X |
| Taxonomy | Assistant Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: