Provider Demographics
NPI:1336766575
Name:TRUONG, TRAN (RN, BSN)
Entity Type:Individual
Prefix:
First Name:TRAN
Middle Name:
Last Name:TRUONG
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10824 AMBLEWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-3347
Mailing Address - Country:US
Mailing Address - Phone:512-501-0377
Mailing Address - Fax:
Practice Address - Street 1:10824 AMBLEWOOD WAY
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753-3347
Practice Address - Country:US
Practice Address - Phone:512-501-0377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-04
Last Update Date:2020-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXGPRN243870163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics