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Individual

DR. PHONG QUOC TRAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
20103 OLD SCENIC HWY STE 2B, ZACHARY, LA 70791
(225) 570-2753
(225) 570-2758
Mailing address
20103 OLD SCENIC HWY STE 2B, ZACHARY, LA 70791-7386
(225) 570-2753
(225) 570-2758

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1629-662T
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2443381
LA
Enumeration date
07/28/2011
Last updated
07/10/2018
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