Provider Demographics
NPI:1326708991
Name:YU, TINA TRAN (AGPCNP)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:TRAN
Last Name:YU
Suffix:
Gender:F
Credentials:AGPCNP
Other - Prefix:
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Mailing Address - Street 1:200 W MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-7644
Mailing Address - Country:US
Mailing Address - Phone:469-733-4391
Mailing Address - Fax:817-702-2140
Practice Address - Street 1:1450 8TH AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4110
Practice Address - Country:US
Practice Address - Phone:817-702-8300
Practice Address - Fax:817-702-8322
Is Sole Proprietor?:No
Enumeration Date:2021-12-23
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1058122363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology