Provider Demographics
NPI:1902356173
Name:TRAN, TUAN (MOT/L)
Entity type:Individual
Prefix:
First Name:TUAN
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:MOT/L
Other - Prefix:
Other - First Name:TONY
Other - Middle Name:
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MOT/L
Mailing Address - Street 1:11508 TWISTED OAK RD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-5336
Mailing Address - Country:US
Mailing Address - Phone:405-229-7539
Mailing Address - Fax:
Practice Address - Street 1:11508 TWISTED OAK RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-5336
Practice Address - Country:US
Practice Address - Phone:405-229-7539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1720225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist