Provider Demographics
NPI:1679571459
Name:TRAN, HARRY HA
Entity type:Individual
Prefix:
First Name:HARRY
Middle Name:HA
Last Name:TRAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:HARRY
Other - Middle Name:HA
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:4900 GARTH RD
Mailing Address - Street 2:STE A
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-2258
Mailing Address - Country:US
Mailing Address - Phone:832-414-2020
Mailing Address - Fax:281-421-0011
Practice Address - Street 1:4900A GARTH RD
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-2144
Practice Address - Country:US
Practice Address - Phone:281-421-1122
Practice Address - Fax:281-421-1127
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6695TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX183789001Medicaid