Provider Demographics
NPI:1730460239
Name:TRAN, SHAWN QUANG (DDS, DMD)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:QUANG
Last Name:TRAN
Suffix:
Gender:M
Credentials:DDS, DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8501 S SAM HOUSTON PKWY E
Mailing Address - Street 2:SUITE D-110
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77075-4857
Mailing Address - Country:US
Mailing Address - Phone:713-300-1470
Mailing Address - Fax:713-991-2637
Practice Address - Street 1:8501 S SAM HOUSTON PKWY E
Practice Address - Street 2:SUITE D-110
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77075-4857
Practice Address - Country:US
Practice Address - Phone:713-300-1470
Practice Address - Fax:713-991-2637
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-30
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010205471223G0001X
TX27364122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice