Individual
PHUONG NGOC TRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1515 HOLCOMBE BLVD, SUITE 1MC 8.2351, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
AP139779
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
403909101
—
TX
01
—
403909102
MEDICAID-CSHCN
TX
01
—
8LW439
BCBS
TX
Enumeration date
06/18/2019
Last updated
12/17/2019
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