Provider Demographics
NPI:1003988148
Name:TRAN, THUY D (MD)
Entity Type:Individual
Prefix:DR
First Name:THUY
Middle Name:D
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:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:MERKEL
Mailing Address - State:TX
Mailing Address - Zip Code:79536-0219
Mailing Address - Country:US
Mailing Address - Phone:325-928-5318
Mailing Address - Fax:325-928-3427
Practice Address - Street 1:604 ASH STREET
Practice Address - Street 2:
Practice Address - City:MERKEL
Practice Address - State:TX
Practice Address - Zip Code:79536
Practice Address - Country:US
Practice Address - Phone:325-928-5318
Practice Address - Fax:325-928-3427
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF2066207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00FC55Medicare ID - Type Unspecified
C22755Medicare UPIN