Provider Demographics
NPI:1861414005
Name:TRAN, NHU QUYNH (DO)
Entity type:Individual
Prefix:
First Name:NHU
Middle Name:QUYNH
Last Name:TRAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3110 LAMESA DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-4201
Mailing Address - Country:US
Mailing Address - Phone:972-675-3818
Mailing Address - Fax:214-703-0808
Practice Address - Street 1:3110 LAMESA DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-4201
Practice Address - Country:US
Practice Address - Phone:972-675-3818
Practice Address - Fax:214-703-0808
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2844207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8BD800OtherBLUE CROSS BLUE SHIELD
8F9240Medicare PIN
I59718Medicare UPIN