Individual
DR. THOMAS VAN TRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
350 ROBERT SMALLS PKWY, BEAUFORT, SC 29906-4284
(843) 522-9755
(843) 521-3085
Mailing address
20 HAYEK ST, BEAUFORT, SC 29907-2068
(843) 522-0613
(843) 521-3085
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1239
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7679
MEDICARE GROUP #
SC
05
—
D12396
—
SC
01
—
DA9742
MEDICAID GROUP #
SC
Enumeration date
11/11/2006
Last updated
07/08/2007
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