Provider Demographics
NPI:1194977041
Name:TRAN, LISA L (DDS, MS)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:L
Last Name:TRAN
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3530 SUNSET MEADOWS DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-8865
Mailing Address - Country:US
Mailing Address - Phone:281-648-8400
Mailing Address - Fax:281-648-8401
Practice Address - Street 1:3530 SUNSET MEADOWS DR
Practice Address - Street 2:SUITE 108
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-8865
Practice Address - Country:US
Practice Address - Phone:281-648-8400
Practice Address - Fax:281-648-8401
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-22
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX222751223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics