Provider Demographics
NPI:1083726376
Name:TRAHAN, MICHAEL D (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:D
Last Name:TRAHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6431 FANNIN ST # 4.020
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1501
Mailing Address - Country:US
Mailing Address - Phone:713-500-7279
Mailing Address - Fax:434-654-7752
Practice Address - Street 1:11920 ASTORIA BLVD STE 460
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-6155
Practice Address - Country:US
Practice Address - Phone:713-486-7650
Practice Address - Fax:832-328-0686
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3164208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00X569M07Medicare PIN
VAP00604277Medicare PIN
H49297Medicare UPIN