Provider Demographics
NPI:1255601530
Name:TRANG T THAN OD PA
Entity type:Organization
Organization Name:TRANG T THAN OD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:MS
Authorized Official - First Name:TRANG
Authorized Official - Middle Name:
Authorized Official - Last Name:THAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:832-229-7375
Mailing Address - Street 1:9514 SUMMER RUN DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-5381
Mailing Address - Country:US
Mailing Address - Phone:832-229-7375
Mailing Address - Fax:936-273-3915
Practice Address - Street 1:19091 INTERSTATE 45 S
Practice Address - Street 2:STE A
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385-8748
Practice Address - Country:US
Practice Address - Phone:936-273-3915
Practice Address - Fax:936-273-3915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7615TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty