Provider Demographics
NPI:1043722648
Name:HAN, TRINH TO (NP-BC)
Entity Type:Individual
Prefix:
First Name:TRINH
Middle Name:TO
Last Name:HAN
Suffix:
Gender:F
Credentials:NP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 GROVEWAY DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77087-1122
Mailing Address - Country:US
Mailing Address - Phone:713-644-1568
Mailing Address - Fax:
Practice Address - Street 1:4501 GROVEWAY DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77087-1122
Practice Address - Country:US
Practice Address - Phone:713-644-1568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-04
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF07171410208000000X
TXAP134829363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty