Provider Demographics
NPI:1457417636
Name:TRAN, UYEN M (OD)
Entity Type:Individual
Prefix:
First Name:UYEN
Middle Name:M
Last Name:TRAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:UYEN
Other - Middle Name:M
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:2722 W. GRAND PARKWAY N
Mailing Address - Street 2:SUITE 120
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493
Mailing Address - Country:US
Mailing Address - Phone:346-702-3937
Mailing Address - Fax:832-437-9651
Practice Address - Street 1:2722 W. GRAND PARKWAY N
Practice Address - Street 2:SUITE 120
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493
Practice Address - Country:US
Practice Address - Phone:346-702-3937
Practice Address - Fax:832-437-9651
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6513TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB159036Medicare PIN
8F7763Medicare PIN