Provider Demographics
NPI:1477665966
Name:TRAN, JAMES LE THANH (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LE THANH
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
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 8079
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77508-8079
Mailing Address - Country:US
Mailing Address - Phone:713-378-0738
Mailing Address - Fax:713-378-4419
Practice Address - Street 1:4004 WOODLAWN AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-1921
Practice Address - Country:US
Practice Address - Phone:713-378-0738
Practice Address - Fax:713-378-4419
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4766207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX172154001Medicaid
TX172154001Medicaid
TX8B2928Medicare PIN