Provider Demographics
NPI:1144340019
Name:THOMASVTRAN, OD, PA
Entity type:Organization
Organization Name:THOMASVTRAN, OD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:VAN
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:843-522-0613
Mailing Address - Street 1:20 HAYEK ST
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29907-2068
Mailing Address - Country:US
Mailing Address - Phone:843-522-0613
Mailing Address - Fax:843-521-3085
Practice Address - Street 1:350 ROBERT SMALLS PKWY
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29906-4284
Practice Address - Country:US
Practice Address - Phone:843-522-9755
Practice Address - Fax:843-521-3085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC1238, SC1239152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1518030485OtherDR. EMILY B. TRAN'S NPI #
SCD12387Medicaid
SCDB3713OtherRAILROAD MC GROUP#
SC$$$$$$$$$OtherEMILY TRAN'S SSN
SC1871664904OtherDR THOMAS V TRAN'S NPI #
SCDA9742Medicaid
SCP00100411OtherRAILROAD MC PIN #
SCD12396Medicaid
SC$$$$$$$$$OtherTHOMAS TRAN'S SSN
SCU95827Medicare UPIN