Provider Demographics
NPI:1851724918
Name:JOEY D. TRAN, OD PLLC
Entity Type:Organization
Organization Name:JOEY D. TRAN, OD PLLC
Other - Org Name:JOEY D. TRAN, OD PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEY
Authorized Official - Middle Name:D
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:972-904-3237
Mailing Address - Street 1:5334 ROSS AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-7402
Mailing Address - Country:US
Mailing Address - Phone:469-334-0888
Mailing Address - Fax:
Practice Address - Street 1:5334 ROSS AVE STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-7402
Practice Address - Country:US
Practice Address - Phone:469-334-0888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8165TG261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center