Provider Demographics
NPI:1467653469
Name:NGUYEN X TRAN & ASSOCIATES
Entity Type:Organization
Organization Name:NGUYEN X TRAN & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NGUYEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:972-487-7619
Mailing Address - Street 1:3602 W WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-6236
Mailing Address - Country:US
Mailing Address - Phone:972-487-7619
Mailing Address - Fax:972-487-7682
Practice Address - Street 1:3602 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-6236
Practice Address - Country:US
Practice Address - Phone:972-487-7619
Practice Address - Fax:972-487-7682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7902207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177412701Medicaid
TX0097NHOtherBLUE CROSS BLUE SHIELD
TX0097NHOtherBLUE CROSS BLUE SHIELD
TX00617ZMedicare PIN