Healthcare Provider Details

I. General information

NPI: 1588915706
Provider Name (Legal Business Name): TERESA TRAN MACLEOD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2012
Last Update Date: 03/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28533 SPRING TRAILS RDG STE 125
SPRING TX
77386-4355
US

IV. Provider business mailing address

28533 SPRING TRAILS RDG STE 125
SPRING TX
77386-4355
US

V. Phone/Fax

Practice location:
  • Phone: 281-419-5993
  • Fax: 281-292-6248
Mailing address:
  • Phone: 281-419-5993
  • Fax: 281-292-6248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number680781
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: