Provider Demographics
NPI:1982488243
Name:TRAN, CINDY TUYET (PA-C)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:TUYET
Last Name:TRAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 DOVER GLEN DR
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-1863
Mailing Address - Country:US
Mailing Address - Phone:616-419-9931
Mailing Address - Fax:
Practice Address - Street 1:55 HUMPHREYS CENTER DR STE 200
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2366
Practice Address - Country:US
Practice Address - Phone:901-747-0040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5455208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine