Provider Demographics
NPI:1053592949
Name:TRANG THUY TRINH, MD, PA
Entity type:Organization
Organization Name:TRANG THUY TRINH, MD, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:QUYEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TRINH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:281-646-0740
Mailing Address - Street 1:21770 KINGSLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2513
Mailing Address - Country:US
Mailing Address - Phone:281-646-0740
Mailing Address - Fax:281-646-0743
Practice Address - Street 1:21770 KINGSLAND BLVD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2513
Practice Address - Country:US
Practice Address - Phone:281-646-0740
Practice Address - Fax:281-646-0743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6776207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX140922901Medicaid
TX130856101Medicaid