MEDICARE: KYLE TRAN DDS

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	390200000X	Student in an Organized Health Care Education/Training Program
2	122300000X	Dentist	37100	TX

General Provider Information

NPI Number	:	1376168146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLE TRAN DDS

Provider Business Mailing Address
First Line	:	5240 FM 2920 RD UNIT 400
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77388-3003
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5240 FM 2920 RD UNIT 400
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77388-3003
Country	:	US
Telephone Number	:	713-804-7644
Fax Number	:

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

Provider Enumeration Date	:	06/08/2020
Last Update Date	:	08/18/2021

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Directions to “ KYLE TRAN DDS” Practice Location

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