Provider Demographics
NPI:1629259510
Name:TRAN, LARRY (MD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16605 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 600
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3501
Mailing Address - Country:US
Mailing Address - Phone:281-494-6387
Mailing Address - Fax:281-494-6410
Practice Address - Street 1:16605 SOUTHWEST FWY
Practice Address - Street 2:SUITE 600
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3501
Practice Address - Country:US
Practice Address - Phone:281-494-6387
Practice Address - Fax:281-494-6410
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP03122084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX305568301Medicaid
TX305568302Medicaid
TXP01392341OtherRR MEDICARE
TX1629259510OtherBLUE CROSS BLUE SHIELD
TXP01142222OtherRR MEDICARE
TX8DF382OtherBLUE CROSS BLUE SHIELD
TX305568301Medicaid
TX309995YQ64Medicare PIN