MEDICARE: FOREFRONT PHYSICIANS PLLC

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	P3089	TX

General Provider Information

NPI Number	:	1386009462
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOREFRONT PHYSICIANS PLLC

Provider Business Mailing Address
First Line	:	7051 FM 1464 RD
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-9542
Country	:	US
Telephone Number	:	281-961-3217
Fax Number	:

Provider Business Practice Location Address
First Line	:	7051 FM 1464 RD
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-9542
Country	:	US
Telephone Number	:	281-961-3217
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ETHAN TRAN
Credential	:	MD
Telephone Number	:	281-961-3217

Provider Enumeration Date	:	12/16/2015
Last Update Date	:	12/16/2015

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