Provider Demographics
NPI:1043535289
Name:TRAN, KATHERINE KIM NGUYEN (OD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:KIM NGUYEN
Last Name:TRAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:KATHERINE
Other - Middle Name:KIM
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:7710 BEECHNUT ST STE 100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-3106
Mailing Address - Country:US
Mailing Address - Phone:713-777-7145
Mailing Address - Fax:
Practice Address - Street 1:7710 BEECHNUT ST STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-3106
Practice Address - Country:US
Practice Address - Phone:713-777-7145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7189TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2202012-01Medicaid
TXB116046OtherMEDICARE
TX2202012-01Medicaid