Provider Demographics
NPI:1841627395
Name:TRAN, MAXWELL QUANG (DC)
Entity type:Individual
Prefix:DR
First Name:MAXWELL
Middle Name:QUANG
Last Name:TRAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:29818 FM 1093 RD STE 205
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441-3919
Mailing Address - Country:US
Mailing Address - Phone:812-346-8023
Mailing Address - Fax:281-346-8045
Practice Address - Street 1:29818 FM 1093 RD STE 205
Practice Address - Street 2:
Practice Address - City:FULSHEAR
Practice Address - State:TX
Practice Address - Zip Code:77441-3919
Practice Address - Country:US
Practice Address - Phone:281-346-8023
Practice Address - Fax:281-346-8045
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-30
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX12452111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Z147OtherMEDICARE