Provider Demographics
NPI:1467976910
Name:TRAN, ANNIE (DOCTOR OR OPTOMETRY)
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:DOCTOR OR OPTOMETRY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 79591
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21279-0591
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:866-795-4020
Practice Address - Street 1:6406 SPRINGFIELD PLZ
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-3428
Practice Address - Country:US
Practice Address - Phone:703-451-4577
Practice Address - Fax:703-451-8549
Is Sole Proprietor?:No
Enumeration Date:2017-07-26
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002595152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist