Basic Information
| Provider Information | |||||||||
| NPI: | 1689102717 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TRAN | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | DUC-TUAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 122 W JOHN CARPENTER FWY STE 420 | ||||||||
| Address2: | |||||||||
| City: | IRVING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750392014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9729573000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 321 N PRESTON RD STE C | ||||||||
| Address2: | |||||||||
| City: | PROSPER | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750788882 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4694884900 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2017 | ||||||||
| LastUpdateDate: | 12/28/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | BP10061558 | TX | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | S5280 | TX | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.