Provider Demographics
NPI:1093873358
Name:TRAN, SUZANA CHAU (FNP)
Entity type:Individual
Prefix:MRS
First Name:SUZANA
Middle Name:CHAU
Last Name:TRAN
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6908 CATAMARAN DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75054-7219
Mailing Address - Country:US
Mailing Address - Phone:817-575-7718
Mailing Address - Fax:
Practice Address - Street 1:2727 BOLTON BOONE DR STE 114
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2019
Practice Address - Country:US
Practice Address - Phone:469-857-3142
Practice Address - Fax:469-857-3077
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX649018363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX191328703Medicaid
TX8Y1079OtherBCBS
TX8J4706Medicare PIN
TX8Y1079OtherBCBS
TXQ79391Medicare UPIN