Provider Demographics
NPI:1710391099
Name:TRAN, DEVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:DEVIN
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 HENNESSY BLVD STE 4000
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-0306
Mailing Address - Country:US
Mailing Address - Phone:225-769-9637
Mailing Address - Fax:225-769-6343
Practice Address - Street 1:7777 HENNESSY BLVD STE 4000
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-0306
Practice Address - Country:US
Practice Address - Phone:225-766-7441
Practice Address - Fax:225-766-7597
Is Sole Proprietor?:No
Enumeration Date:2014-06-16
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA312198207W00000X, 207WX0120X
MST-2857207W00000X
MS25261207W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty
No207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA312198OtherLSBME MEDICAL LICENSE
LA312198Medicaid
MST-2857OtherMS TRAINING LICENSE
MS25261OtherVETERAN'S AFFAIRS