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Individual

MR. JODY G TRAHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN, CNOR

Contact information

Practice address
17424 W GRAND PKWY S # 122, SUGAR LAND, TX 77479-2564
(409) 673-1128
(866) 360-3539
Mailing address
17424 W GRAND PKWY S # 122, SUGAR LAND, TX 77479-2564
(409) 673-1128
(866) 360-3539

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
597248
TX
163WR0006X
Registered Nurse First Assistant
Primary
597248
TX
246ZS0410X
Surgical Technologist
597248
TX

Other

Enumeration date
03/05/2007
Last updated
04/28/2014
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