Provider Demographics
NPI:1710955711
Name:VAN-HIEN C TRAN P A
Entity Type:Organization
Organization Name:VAN-HIEN C TRAN P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VAN-HIEN
Authorized Official - Middle Name:CONG
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-578-8787
Mailing Address - Street 1:PO BOX 4346
Mailing Address - Street 2:DEPT# 31
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4346
Mailing Address - Country:US
Mailing Address - Phone:281-578-8787
Mailing Address - Fax:281-578-8764
Practice Address - Street 1:701 S FRY RD
Practice Address - Street 2:SUITE# 115
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2255
Practice Address - Country:US
Practice Address - Phone:281-578-8787
Practice Address - Fax:281-578-8764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-08
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5720208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0066JVOtherBCBS
TX160151001Medicaid
TX00151VMedicare PIN
TXH34465Medicare UPIN