Provider Demographics
NPI:1649915422
Name:TRAN, GIANG TRUONG (PA-C)
Entity type:Individual
Prefix:
First Name:GIANG
Middle Name:TRUONG
Last Name:TRAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2781 N CARROLL AVE APT 420
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-3845
Mailing Address - Country:US
Mailing Address - Phone:512-584-3316
Mailing Address - Fax:
Practice Address - Street 1:621 N HALL ST STE 500
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75226-1301
Practice Address - Country:US
Practice Address - Phone:469-800-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA15475363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant