Provider Demographics
NPI:1275647687
Name:QUYEN H. TRAN, O.D., PLLC
Entity Type:Organization
Organization Name:QUYEN H. TRAN, O.D., PLLC
Other - Org Name:SIMPLY EYES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:QUYEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:972-939-1900
Mailing Address - Street 1:105 WOODLAND CV
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-2034
Mailing Address - Country:US
Mailing Address - Phone:972-745-1671
Mailing Address - Fax:972-939-1911
Practice Address - Street 1:1628 W. HEBRON PKWY
Practice Address - Street 2:SUITE 134
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010
Practice Address - Country:US
Practice Address - Phone:972-939-1900
Practice Address - Fax:972-939-1911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5347T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX103556003Medicaid
TX103556003Medicaid
TX612523Medicare PIN