1548240799 NPI number — LOANN T TRINH D.O.

Table of content: LOANN T TRINH D.O. (NPI 1548240799)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548240799 NPI number — LOANN T TRINH D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TRINH
Provider First Name:
LOANN
Provider Middle Name:
T
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1548240799
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/28/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8557 RESEARCH BLVD STE 128
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78758-7855
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-836-7399
Provider Business Mailing Address Fax Number:
512-836-7378

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8557 RESEARCH BLVD
Provider Second Line Business Practice Location Address:
SUITE # 128
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78758-7856
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-836-7399
Provider Business Practice Location Address Fax Number:
512-836-7378
Provider Enumeration Date:
01/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  L1765 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207QS0010X , with the licence number: L1765 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208D00000X , with the licence number: L1765 , 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)

  • Identifier: 156157303 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 156157307 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8K3000 . This is a "BCBS OF TEXAS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8V0603 . This is a "BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: P00157288 . This is a "RAILROAD MCARE PROV NO" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 156157306 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 156157308 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8W2942 . This is a "BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 161008101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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