# KENNY-BAO THAI TRAN, MD, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043626955
- **Authorized official:** KENNY-BAO THAI TRAN MD (OWNER)
- **Authorized official phone:** (512) 942-4700

## Contact information

- **Practice address:** 2000 SCENIC DR, GEORGETOWN, TX 78626-7726
- **Practice address phone:** (512) 942-4700
- **Mailing address:** PO BOX 924, AUSTIN, TX 78767-0924
- **Mailing address phone:** (512) 474-5700
- **Mailing address fax:** (512) 474-2720

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/11/2014
- **Last updated:** 05/28/2021