Provider Demographics
NPI:1942081880
Name:TRAN, DUY (CRNA)
Entity type:Individual
Prefix:
First Name:DUY
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:64 MISTY MESA TRL
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-4854
Mailing Address - Country:US
Mailing Address - Phone:817-718-2930
Mailing Address - Fax:
Practice Address - Street 1:2221 LAKESIDE BLVD STE 600
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-4416
Practice Address - Country:US
Practice Address - Phone:469-505-1652
Practice Address - Fax:469-436-3976
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1138743367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty