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Individual

JIMMY TRAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
2201 WESTGATE PLZ, GRAPEVINE, TX 76051-8037
(817) 410-2030
(817) 251-6261
Mailing address
2201 WESTGATE PLZ, GRAPEVINE, TX 76051-8037
(817) 410-2030
(817) 251-6261

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
4559
MA
152W00000X
Optometrist
Primary
6855TG
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
309756003
TX
Enumeration date
04/21/2006
Last updated
05/27/2022
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