Individual
KIEN T. TRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
6800 HERITAGE PKWY, SUITE 100, ROCKWALL, TX 75087-8746
(972) 475-5300
(972) 475-5303
Mailing address
PO BOX 601799, DALLAS, TX 75360-1799
(214) 893-9677
(972) 475-5303
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
N3356
TX
207ND0900X
Dermatopathology Physician
N3356
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61670
GEORGIA MEDICAL LICENSE
GA
01
—
BP1-0026121
INSTITUTIONAL PERMIT
—
01
—
N3356
TEXAS MEDICAL LICENSE
TX
Enumeration date
05/31/2007
Last updated
03/07/2023
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