Provider Demographics
NPI:1801980685
Name:TRAN, TARA ANH (OD)
Entity type:Individual
Prefix:DR
First Name:TARA
Middle Name:ANH
Last Name:TRAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:LANG
Other - Middle Name:
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1308 TANGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-7696
Mailing Address - Country:US
Mailing Address - Phone:817-292-9888
Mailing Address - Fax:817-210-0039
Practice Address - Street 1:5300 OVERTON RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-3301
Practice Address - Country:US
Practice Address - Phone:817-292-9888
Practice Address - Fax:817-210-0039
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDA2013152W00000X
TX7316T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist