MEDICARE: HOUSTON HEAD AND NECK SURGICAL PA

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	207YX0905X	Otolaryngology/Facial Plastic Surgery Physician	L8981	TX

General Provider Information

NPI Number	:	1528165438
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSTON HEAD AND NECK SURGICAL PA

Provider Business Mailing Address
First Line	:	10311 N ELDRIDGE PKWY
Second Line	:	#B4
City	:	HOUSTON
State	:	TX
Zip	:	77065-5368
Country	:	US
Telephone Number	:	281-897-1112
Fax Number	:	281-897-9993

Provider Business Practice Location Address
First Line	:	10311 N ELDRIDGE PKWY
Second Line	:	#B4
City	:	HOUSTON
State	:	TX
Zip	:	77065-5368
Country	:	US
Telephone Number	:	281-897-1112
Fax Number	:	281-897-9993

Authorized Official
Title or Position	:	PHYSICIAN OWNER
Name	:	DR. KHOA DINH TRAN
Credential	:	MD
Telephone Number	:	281-897-1112

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	06/06/2008

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1124011945 — KHOA D TRAN M.D.
Practice Location Address:

10311 N ELDRIDGE PKWY , #B-4
HOUSTON, TX
77065-5368

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1417938879 — MS. GAIL T WELLS RN,MS,FNP-C
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10311 N ELDRIDGE PKWY , STE. B5
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1982709465 — SYED NASER MUJEEB MD
Practice Location Address:

10311 N ELDRIDGE PKWY , STE B5
HOUSTON, TX
77065-5368

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1861598666 — JOLIE DENTAL
Practice Location Address:

10311 N ELDRIDGE PKWY , SUITE B-7
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1972777993 — JOLIE CHU DDS
Practice Location Address:

10311 N ELDRIDGE PKWY , SUITE B-7
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1316371263 — PHYSICIANS URGENT CARE PLLC
Practice Location Address:

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