Provider Demographics
NPI:1639377104
Name:TRAN-LOCKWOOD, JULIE M (OD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:TRAN-LOCKWOOD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9409 US HIGHWAY 19
Mailing Address - Street 2:#443
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-4625
Mailing Address - Country:US
Mailing Address - Phone:727-848-2977
Mailing Address - Fax:727-844-0769
Practice Address - Street 1:9409 US HIGHWAY 19
Practice Address - Street 2:#443
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-4625
Practice Address - Country:US
Practice Address - Phone:727-848-2977
Practice Address - Fax:727-844-0769
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4594152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist