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General NPI Number Information
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NPI Number | 1902459787
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Entity Type | Individual
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Provider Name | MARY TRAN DC
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Gender | Female
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Dates
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Enumeration Date | 07/19/2019
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Last Update Date | 07/19/2019
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Provider Practice Location Address
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Address Line | 615 NORTH LOOP E STE 200
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City | HOUSTON
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State | TX
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Zip | 77022-5934
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Country | US
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Telephone | 832-380-2580
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Fax |
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Provider Business Mailing Address
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Address Line | 11719 LAMPREY ST
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City | HOUSTON
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State | TX
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Zip | 77099-4022
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Country | US
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Telephone | 832-228-5833
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 13288
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License Number State | TX
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