=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386644342
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DUNG T. TRAN MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/29/2005
-----------------------------------------------------
Last Update Date | 05/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3848 VETERANS MEMORIAL BLVD STE 101
-----------------------------------------------------
City | METAIRIE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70002-5636
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-885-2505
-----------------------------------------------------
Fax | 504-885-2510
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3848 VETERANS MEMORIAL BLVD STE 101
-----------------------------------------------------
City | METAIRIE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70002-5636
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-885-2505
-----------------------------------------------------
Fax | 504-887-3797
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 025373
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------