MEDICARE: DR. TRAN OD PROFESSIONAL CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	371	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053578336
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. TRAN OD PROFESSIONAL CORP

Provider Business Mailing Address
First Line	:	8826 S EASTERN AVE STE 112
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-4826
Country	:	US
Telephone Number	:	702-942-6301
Fax Number	:	702-942-6303

Provider Business Practice Location Address
First Line	:	8826 S EASTERN AVE STE 112
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-4826
Country	:	US
Telephone Number	:	702-942-6301
Fax Number	:	702-942-6303

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JANET TRAN
Credential	:	OD
Telephone Number	:	702-942-6301

Provider Enumeration Date	:	05/22/2008
Last Update Date	:	05/22/2008

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Directions to “DR. TRAN OD PROFESSIONAL CORP ” Practice Location

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