Provider Demographics
NPI:1265627202
Name:TRAN, ANHTHUY DUY (OD)
Entity type:Individual
Prefix:DR
First Name:ANHTHUY
Middle Name:DUY
Last Name:TRAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:WILLIAM
Other - Middle Name:
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:1800 BERING DR STE 200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-3158
Mailing Address - Country:US
Mailing Address - Phone:713-490-0880
Mailing Address - Fax:713-490-0885
Practice Address - Street 1:1800 BERING DR STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-3158
Practice Address - Country:US
Practice Address - Phone:713-490-0880
Practice Address - Fax:713-490-0885
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8279TG152W00000X
TX6147T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX197751401Medicaid
TX197751401Medicaid