Provider Demographics
NPI:1801108311
Name:TRAN, VY AI (PA-C)
Entity type:Individual
Prefix:MRS
First Name:VY
Middle Name:AI
Last Name:TRAN
Suffix:
Gender:F
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:P.O. BOX 722225
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73070
Mailing Address - Country:US
Mailing Address - Phone:405-292-5500
Mailing Address - Fax:405-292-5505
Practice Address - Street 1:2201 SW 119TH STREET
Practice Address - Street 2:SUITE A
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170
Practice Address - Country:US
Practice Address - Phone:405-735-9788
Practice Address - Fax:405-735-9882
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52263363A00000X
OK1677133V00000X
OK2656363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered