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NPI Code Detail

MEDICARE: LILY N TRAN DO

MEDICARE: LILY N TRAN DO
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
1207Q00000XFamily Medicine PhysicianL7584TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1265489330
Entity Type Code : Individual
Provider Name (Legal Business Name) : LILY N TRAN DO
Provider Business Mailing Address
First Line : 2550 RIVER PARK PLZ
Second Line : SUITE 110
City : FORT WORTH
State : TX
Zip : 76116-0920
Country : US
Telephone Number : 817-731-1289
Fax Number : 817-731-1291
Provider Business Practice Location Address
First Line : 2550 RIVER PARK PLZ
Second Line : SUITE 110
City : FORT WORTH
State : TX
Zip : 76116-0920
Country : US
Telephone Number : 817-731-1289
Fax Number : 817-731-1291
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2006
Last Update Date : 12/14/2015

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Directions to “ LILY N TRAN DO” Practice Location

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