=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568527604
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | QUOC-HUNG TRAN MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/27/2006
-----------------------------------------------------
Last Update Date | 09/10/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 17736 PRESTON RD STE 101
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75252-5726
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-248-2299
-----------------------------------------------------
Fax | 972-248-2012
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 17736 PRESTON RD STE 101
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75252-5726
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-248-2299
-----------------------------------------------------
Fax | 972-248-2012
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. QUOC-HUNG TRAN
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 972-248-2299
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | J7291
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------