Provider Demographics
NPI:1770570913
Name:TRAN, PHUONG LE (MD)
Entity type:Individual
Prefix:DR
First Name:PHUONG
Middle Name:LE
Last Name:TRAN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:4202 SW LEE BLVD
Mailing Address - Street 2:BLDG A SUITE 106
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505
Mailing Address - Country:US
Mailing Address - Phone:580-353-0395
Mailing Address - Fax:580-248-8313
Practice Address - Street 1:4202 SW LEE BLVD
Practice Address - Street 2:BLDG A SUITE 106
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505
Practice Address - Country:US
Practice Address - Phone:580-353-0395
Practice Address - Fax:580-248-8313
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2010-02-03
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Provider Licenses
StateLicense IDTaxonomies
OK141192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry