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General NPI Number Information
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NPI Number | 1184284275
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Entity Type | Organization
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Legal Business Name | ANDREW L. TRANG, OD PLLC
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Dates
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Enumeration Date | 06/19/2019
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Last Update Date | 06/19/2019
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Provider Practice Location Address
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Address Line | 215 GRAND AVE
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City | SOUTHLAKE
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State | TX
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Zip | 76092-7605
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Country | US
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Telephone | 817-602-9813
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Fax |
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Provider Business Mailing Address
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Address Line | 439 E GREENBRIAR LN
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City | DALLAS
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State | TX
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Zip | 75203-1000
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | ANDREW TRANG
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Credential |
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Telephone | 817-602-9813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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