Provider Demographics
NPI:1386736569
Name:TRAN, JANET NGUYET (OD)
Entity type:Individual
Prefix:DR
First Name:JANET
Middle Name:NGUYET
Last Name:TRAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4116 W CRAIG RD STE 104
Mailing Address - Street 2:
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-2733
Mailing Address - Country:US
Mailing Address - Phone:702-631-2015
Mailing Address - Fax:702-631-2511
Practice Address - Street 1:4116 W CRAIG RD STE 104
Practice Address - Street 2:
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-2733
Practice Address - Country:US
Practice Address - Phone:702-631-2015
Practice Address - Fax:702-631-2511
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV371152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002502042Medicaid
NVU73338Medicare UPIN
U73338Medicare UPIN
NV002502042Medicaid