# FULL MOON PHYSICIAN, LLLP

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

## Provider details

- **NPI number:** 1831430370
- **Authorized official:** DR. GIANG LUONG TRAN MD (PRESIDENT, FULL MOON PHYSICIAN MGT)
- **Authorized official phone:** (281) 829-3999

## Contact information

- **Practice address:** 2430 FRY RD, STE 100, HOUSTON, TX 77084-5831
- **Practice address phone:** (281) 829-3999
- **Practice address fax:** (281) 829-5146
- **Mailing address:** 2430 FRY RD, STE 100, HOUSTON, TX 77084-5831
- **Mailing address phone:** (281) 829-3999
- **Mailing address fax:** (281) 829-5146

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | K9440 | TX | Yes |

## Other

- **Enumeration date:** 03/08/2013
- **Last updated:** 03/08/2013