Provider Demographics
NPI:1679841340
Name:TRAN, PHUONG MY (RN, NP)
Entity Type:Individual
Prefix:
First Name:PHUONG
Middle Name:MY
Last Name:TRAN
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10623 BELLAIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-5242
Mailing Address - Country:US
Mailing Address - Phone:713-486-5900
Mailing Address - Fax:713-486-5901
Practice Address - Street 1:10623 BELLAIRE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-1499
Practice Address - Country:US
Practice Address - Phone:713-486-5900
Practice Address - Fax:713-486-5901
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-08
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX662981363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily