1417275207 NPI number — DR. TOAN A TRAN AND ASSOCIATES CORP

Table of content: (NPI 1417275207)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417275207 NPI number — DR. TOAN A TRAN AND ASSOCIATES CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR. TOAN A TRAN AND ASSOCIATES CORP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
COLLEGE OPTICAL EXPRESS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417275207
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/04/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4308 KESTREL WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CARROLLTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75010-4683
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-365-7029
Provider Business Mailing Address Fax Number:
940-369-7403

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1800 W CHESTNUT ST
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
DENTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
940-369-7441
Provider Business Practice Location Address Fax Number:
940-369-7403
Provider Enumeration Date:
05/04/2010

Additional Information

Authorized Official

Authorized Official Last Name:
TRAN
Authorized Official First Name:
TOAN
Authorized Official Middle Name:
A
Authorized Official Title or Position:
THERAPEUTIC OPTOMETRIST
Authorized Official Telephone Number:
940-369-7441

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  7387TG , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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