Healthcare Provider Details

I. General information

NPI: 1518943539
Provider Name (Legal Business Name): HA-PHUONG T TRAN OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HA-PHUONG T PHAM

II. Dates (important events)

Enumeration Date: 12/21/2005
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6231 LEESBURG PIKE #608
FALLS CHURCH VA
22044-2102
US

IV. Provider business mailing address

6231 LEESBURG PIKE #608
FALLS CHURCH VA
22044-2102
US

V. Phone/Fax

Practice location:
  • Phone: 703-534-3900
  • Fax: 703-536-3729
Mailing address:
  • Phone: 703-534-3900
  • Fax: 703-536-3729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0618000739
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: