=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386736569
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JANET NGUYET TRAN O.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/28/2006
-----------------------------------------------------
Last Update Date | 11/28/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4116 W CRAIG RD STE 104
-----------------------------------------------------
City | N LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89032-2733
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-631-2015
-----------------------------------------------------
Fax | 702-631-2511
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4116 W CRAIG RD STE 104
-----------------------------------------------------
City | N LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89032-2733
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-631-2015
-----------------------------------------------------
Fax | 702-631-2511
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 371
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------