Individual
CAROL TRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3810 MASTHEAD ST NE, ALBUQUERQUE, NM 87109-4479
(058) 438-7585
(505) 843-8759
Mailing address
3810 MASTHEAD ST NE, ALBUQUERQUE, NM 87109-4479
(505) 843-8758
(505) 843-8759
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA04560
TX
363AM0700X
Medical Physician Assistant
Primary
PA2016-0057
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
840878
BCBS
TX
01
—
P00298578
RAILROAD MEDICARE
—
Enumeration date
06/23/2005
Last updated
05/07/2024
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