1932327749 NPI number — JAMES TRAN MD PA

Table of content: DR. DANA MICHELLE JEAN COMESLAST N.D. (NPI 1023345394)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932327749 NPI number — JAMES TRAN MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JAMES TRAN MD PA
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:
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:
1932327749
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/13/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 8079
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PASADENA
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77508-8079
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-378-0738
Provider Business Mailing Address Fax Number:
713-378-4419

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4004 WOODLAWN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PASADENA
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77504-1921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-378-0738
Provider Business Practice Location Address Fax Number:
713-378-4419
Provider Enumeration Date:
04/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
TRAN
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
LE THANH
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
713-378-0738

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  L4766 , 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: 172154001 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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