Provider Demographics
NPI:1679771836
Name:TRAN, DIEN VAN (DC)
Entity type:Individual
Prefix:DR
First Name:DIEN
Middle Name:VAN
Last Name:TRAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:DIEN
Other - Middle Name:VAN
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:9780 WALNUT ST STE 200
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-2351
Mailing Address - Country:US
Mailing Address - Phone:972-792-7031
Mailing Address - Fax:972-792-7037
Practice Address - Street 1:9780 WALNUT ST STE 200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-2351
Practice Address - Country:US
Practice Address - Phone:972-792-7031
Practice Address - Fax:972-792-7037
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10702111N00000X
CA22188111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor