Provider Demographics
NPI: | 1598043853 |
---|---|
Name: | TONY N. TRAN O.D. PLLC |
Entity Type: | Organization |
Organization Name: | TONY N. TRAN O.D. PLLC |
Other - Org Name: | OPTIMAL EYE CARE |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | DOCTOR |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | TONY |
Authorized Official - Middle Name: | N |
Authorized Official - Last Name: | TRAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | OD |
Authorized Official - Phone: | 281-540-8649 |
Mailing Address - Street 1: | 20777 HIGHWAY 59 N |
Mailing Address - Street 2: | |
Mailing Address - City: | HUMBLE |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 77338-2209 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 281-540-8649 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 20777 HIGHWAY 59 N |
Practice Address - Street 2: | |
Practice Address - City: | HUMBLE |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77338-2209 |
Practice Address - Country: | US |
Practice Address - Phone: | 281-540-8649 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2011-08-03 |
Last Update Date: | 2011-08-03 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | 7510TG | 152W00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 152W00000X | Eye and Vision Services Providers | Optometrist | Group - Single Specialty |