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General NPI Number Information
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NPI Number | 1083412712
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Entity Type | Organization
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Legal Business Name | MAI TRAN MD PA OSLER PEDIATRIC CLINIC
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Dates
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Enumeration Date | 03/06/2025
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 2715 OSLER DR
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City | GRAND PRAIRIE
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State | TX
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Zip | 75051-1051
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Country | US
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Telephone | 469-556-5527
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Fax |
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Provider Business Mailing Address
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Address Line | 4524 RHEIMS PL
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City | DALLAS
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State | TX
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Zip | 75205-3629
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Country | US
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Telephone | 469-556-5527
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MAI TRAN
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Credential | MD
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Telephone | 469-556-5527
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number |
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License Number State |
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