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General NPI Number Information
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NPI Number | 1679977797
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Entity Type | Individual
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Provider Name | DIEM PHUONG NGOC TRAN O.D.
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Gender | Female
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Dates
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Enumeration Date | 10/17/2014
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Last Update Date | 10/17/2014
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Provider Practice Location Address
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Address Line | 13615 BELLAIRE BLVD
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City | HOUSTON
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State | TX
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Zip | 77083-1714
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Country | US
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Telephone | 281-402-8717
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Fax |
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Provider Business Mailing Address
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Address Line | 8250 PARK PLACE BLVD APT 207
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City | HOUSTON
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State | TX
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Zip | 77017-3125
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Country | US
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Telephone | 713-837-6983
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 8270T
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License Number State | TX
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