Provider Demographics
NPI:1629259510
Name:TRAN, LARRY (MD)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16537 SOUTHWEST FWY STE 500
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-7244
Mailing Address - Country:US
Mailing Address - Phone:281-274-7595
Mailing Address - Fax:281-494-6410
Practice Address - Street 1:16537 SOUTHWEST FWY STE 500
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-7244
Practice Address - Country:US
Practice Address - Phone:812-747-5952
Practice Address - Fax:281-494-6410
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP03122084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8DF382OtherBLUE CROSS BLUE SHIELD
TXP01392341OtherRR MEDICARE
TX1629259510OtherBLUE CROSS BLUE SHIELD
TXP01142222OtherRR MEDICARE
TX305568301Medicaid
TX305568302Medicaid
TX305568301Medicaid
TX309995YQ64Medicare PIN