Provider Demographics
NPI:1093812307
Name:TRAN, QUANG TRUC (MD)
Entity Type:Individual
Prefix:DR
First Name:QUANG
Middle Name:TRUC
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:7297 LEE HIGHWAY
Mailing Address - Street 2:SUITE E
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1707
Mailing Address - Country:US
Mailing Address - Phone:703-538-6248
Mailing Address - Fax:702-538-6403
Practice Address - Street 1:7297 LEE HIGHWAY
Practice Address - Street 2:SUITE E
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-1707
Practice Address - Country:US
Practice Address - Phone:703-538-6248
Practice Address - Fax:702-538-6403
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA00101041832207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006068227Medicaid
VA1114287083OtherGROUP NPI
VA1093812307OtherINDIVIDUAL NPI
VAE 13443Medicare UPIN
VA1093812307OtherINDIVIDUAL NPI
VA1114287083OtherGROUP NPI