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General NPI Number Information
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NPI Number | 1205036225
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Entity Type | Individual
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Provider Name | MARYANNE THU TRAN MD
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Gender | Female
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Dates
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Enumeration Date | 07/18/2007
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Last Update Date | 06/01/2018
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Provider Practice Location Address
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Address Line | 800 PEAKWOOD DR STE 5E
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City | HOUSTON
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State | TX
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Zip | 77090
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Country | US
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Telephone | 281-440-5158
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Fax |
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Provider Business Mailing Address
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Address Line | 1101 WALNUT ST UNIT 1505
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City | KANSAS CITY
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State | MO
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Zip | 64106-2134
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Country | US
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Telephone | 816-679-3879
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 2012016184
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 04-35815
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | N1189
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License Number State | TX
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