Provider Demographics
NPI:1093997405
Name:TRAN, HENRY TAI (PT)
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:TAI
Last Name:TRAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:MR
Other - First Name:TAI
Other - Middle Name:BA
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8205 W WARM SPRINGS RD STE 250
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-3646
Mailing Address - Country:US
Mailing Address - Phone:702-294-7493
Mailing Address - Fax:702-252-0369
Practice Address - Street 1:8205 W WARM SPRINGS RD STE 250
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-3646
Practice Address - Country:US
Practice Address - Phone:702-294-7493
Practice Address - Fax:702-252-0369
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2136225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1093997405Medicaid
NV1093997405Medicaid