MEDICARE: MR. BILLY LE TRAN MD

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	207P00000X	Emergency Medicine Physician	W6404	TX
2	207P00000X	Emergency Medicine Physician	DR.0075625	CO

General Provider Information

NPI Number	:	1295392157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BILLY LE TRAN MD

Provider Business Mailing Address
First Line	:	PO BOX 173891
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80217-3891
Country	:	US
Telephone Number	:	877-346-2211
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 E BOULDER ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-5533
Country	:	US
Telephone Number	:	719-365-5221
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2019
Last Update Date	:	05/27/2026

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