MEDICARE: ANDY V. TRAN M.D.

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	23532	LA
2	208M00000X	Hospitalist Physician	023532	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982890836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDY V. TRAN M.D.

Provider Business Mailing Address
First Line	:	365 W HICKORY AVE
Second Line	:
City	:	BASTROP
State	:	LA
Zip	:	71220-4441
Country	:	US
Telephone Number	:	318-283-5999
Fax Number	:	318-283-7998

Provider Business Practice Location Address
First Line	:	365 W HICKORY AVE
Second Line	:
City	:	BASTROP
State	:	LA
Zip	:	71220-4441
Country	:	US
Telephone Number	:	318-283-5999
Fax Number	:	318-283-7998

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

Provider Enumeration Date	:	09/24/2007
Last Update Date	:	04/07/2016

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