Provider Demographics
NPI:1104034586
Name:TRAN, HIEN QUANG (MD)
Entity Type:Individual
Prefix:DR
First Name:HIEN
Middle Name:QUANG
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 1:41335 RUE CHENE
Mailing Address - Street 2:
Mailing Address - City:PONCHATOULA
Mailing Address - State:LA
Mailing Address - Zip Code:70454-7099
Mailing Address - Country:US
Mailing Address - Phone:225-294-9987
Mailing Address - Fax:
Practice Address - Street 1:1809 W AIRLINE HWY
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-3336
Practice Address - Country:US
Practice Address - Phone:985-652-8444
Practice Address - Fax:985-652-2450
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA07920R2084P0015X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA07920ROtherLICENSE
LA1670847Medicaid
LA07920ROtherLICENSE