Individual
LONG TRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
411 N WASHINGTON AVE, DALLAS, TX 75246-1713
(214) 358-2300
(214) 579-6988
Mailing address
1420 VICEROY DR, DALLAS, TX 75235-2208
(214) 358-2300
(214) 366-6127
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
L1223
TX
207RN0300X
Nephrology Physician
Primary
L1223
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L1223
TX LICENSE
TX
Enumeration date
05/09/2006
Last updated
08/15/2023
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