Provider Demographics
NPI:1154196905
Name:TRAN, KIMLOAN
Entity type:Individual
Prefix:
First Name:KIMLOAN
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2146 SWORD DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-6028
Mailing Address - Country:US
Mailing Address - Phone:972-209-3888
Mailing Address - Fax:972-767-0148
Practice Address - Street 1:2146 SWORD DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-6028
Practice Address - Country:US
Practice Address - Phone:972-209-3888
Practice Address - Fax:972-767-0148
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty