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General NPI Number Information
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NPI Number | 1417312018
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Entity Type | Organization
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Legal Business Name | FRONTLINE RICHMOND MEDICAL CENTER LLC
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Dates
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Enumeration Date | 12/23/2015
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Last Update Date | 02/03/2016
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Provider Practice Location Address
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Address Line | 7051 FM 1464 RD
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City | RICHMOND
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State | TX
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Zip | 77407-9542
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Country | US
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Telephone | 281-766-3811
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Fax |
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Provider Business Mailing Address
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Address Line | 7051 FM 1464 RD
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City | RICHMOND
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State | TX
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Zip | 77407-9542
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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 | VICE PRESIDENT
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Name | DR. ETHAN THANH TRAN TRAN
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Credential | M.D.
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Telephone | 281-961-3217
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number | 160216
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License Number State | TX
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