Provider Demographics
NPI:1578758181
Name:TRAN, MICHAEL S (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:S
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:648 W CAMPBELL RD STE B
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3300
Mailing Address - Country:US
Mailing Address - Phone:214-346-9999
Mailing Address - Fax:214-346-9100
Practice Address - Street 1:648 W CAMPBELL RD STE B
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3300
Practice Address - Country:US
Practice Address - Phone:214-346-9999
Practice Address - Fax:214-346-9100
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH4114207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1365452103Medicaid
TX1365452103Medicaid
C22754Medicare UPIN