Provider Demographics
NPI:1407182710
Name:LIEN TRAN GRIFFIN OD PA
Entity Type:Organization
Organization Name:LIEN TRAN GRIFFIN OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LIEN
Authorized Official - Middle Name:TRAN
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:817-919-9037
Mailing Address - Street 1:4800 S HULEN ST
Mailing Address - Street 2:SUITE 146
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-1419
Mailing Address - Country:US
Mailing Address - Phone:817-294-3371
Mailing Address - Fax:817-294-1534
Practice Address - Street 1:4800 S HULEN ST
Practice Address - Street 2:SUITE 146
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-1419
Practice Address - Country:US
Practice Address - Phone:817-294-3371
Practice Address - Fax:817-294-1534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-21
Last Update Date:2010-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5860TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty