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General NPI Number Information
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NPI Number | 1801108311
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Entity Type | Individual
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Provider Name | VY AI TRAN PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/13/2010
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Last Update Date | 08/12/2020
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Provider Practice Location Address
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Address Line | 2201 SW 119TH STREET SUITE A
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City | OKLAHOMA CITY
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State | OK
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Zip | 73170
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Country | US
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Telephone | 405-735-9788
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Fax | 405-735-9882
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Provider Business Mailing Address
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Address Line | P.O. BOX 722225
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City | NORMAN
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State | OK
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Zip | 73070
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Country | US
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Telephone | 405-292-5500
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Fax | 405-292-5505
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 52263
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 1677
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 2656
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License Number State | OK
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