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NPI Code Detail

MEDICARE: MRS. MARY TRAN PT

MEDICARE: MRS. MARY TRAN PT
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
1225100000XPhysical Therapist1166017TX

General Provider Information

NPI Number : 1154433324
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY TRAN PT
Provider Business Mailing Address
First Line : 11306 HARVEST DALE AVE
Second Line :
City : HOUSTON
State : TX
Zip : 77065-3341
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1635 BLALOCK RD
Second Line :
City : HOUSTON
State : TX
Zip : 77080-7320
Country : US
Telephone Number : 713-827-8830
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 07/08/2007

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