MEDICARE: DR. DANIEL LUAN TRAN D.O.

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	207Q00000X	Family Medicine Physician	S0236	TX

General Provider Information

NPI Number	:	1407216310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL LUAN TRAN D.O.

Provider Business Mailing Address
First Line	:	PO BOX 961205
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76161-0205
Country	:	US
Telephone Number	:	817-740-8400
Fax Number	:	817-378-3699

Provider Business Practice Location Address
First Line	:	6009 WESTCREEK DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-3330
Country	:	US
Telephone Number	:	817-292-2560
Fax Number	:	817-292-9230

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

Provider Enumeration Date	:	03/04/2016
Last Update Date	:	01/21/2023

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