1144340019 NPI number — THOMASVTRAN, OD, PA

Table of content: (NPI 1144340019)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144340019 NPI number — THOMASVTRAN, OD, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THOMASVTRAN, OD, 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:
1144340019
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20 HAYEK ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEAUFORT
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29907-2068
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-522-0613
Provider Business Mailing Address Fax Number:
843-521-3085

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
350 ROBERT SMALLS PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEAUFORT
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29906-4284
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-522-9755
Provider Business Practice Location Address Fax Number:
843-521-3085
Provider Enumeration Date:
04/01/2007

Additional Information

Authorized Official

Authorized Official Last Name:
TRAN
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
VAN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
843-522-0613

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  SC1238, SC1239 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1518030485 . This is a "DR. EMILY B. TRAN'S NPI #" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: D12387 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: DB3713 . This is a "RAILROAD MC GROUP#" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: $$$$$$$$$ . This is a "EMILY TRAN'S SSN" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 1871664904 . This is a "DR THOMAS V TRAN'S NPI #" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: DA9742 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00100411 . This is a "RAILROAD MC PIN #" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: D12396 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: $$$$$$$$$ . This is a "THOMAS TRAN'S SSN" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com