Provider Demographics
NPI:1578779419
Name:TRAN, THANH DAI (DC)
Entity Type:Individual
Prefix:
First Name:THANH
Middle Name:DAI
Last Name:TRAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 MEADOW WOOD LN
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-2488
Mailing Address - Country:US
Mailing Address - Phone:281-648-8160
Mailing Address - Fax:713-643-7300
Practice Address - Street 1:401 MEADOW WOOD LN
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-2488
Practice Address - Country:US
Practice Address - Phone:281-648-8160
Practice Address - Fax:713-643-7300
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC8770111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor