Full Moon Physician, LLLP

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

K9440 Issued in TX

Legal business name

FULL MOON PHYSICIAN, LLLP

Practice address

2430 Fry Rd
Ste 100
Houston, TX 77084-5831

Phone

(281) 829-3999

Fax

(281) 829-5146

NPI assigned

Mar 8, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Giang Luong Tran, MD

Title

President, Full Moon Physician MGT

Phone

(281) 829-3999

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1362700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362700800000",
    "number": "1831430370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430 FRY RD",
            "address_2": "STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770845831",
            "telephone_number": "281-829-3999",
            "fax_number": "281-829-5146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 FRY RD",
            "address_2": "STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770845831",
            "telephone_number": "281-829-3999",
            "fax_number": "281-829-5146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL MOON PHYSICIAN, LLLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-08",
        "last_updated": "2013-03-08",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "GIANG",
        "authorized_official_middle_name": "LUONG",
        "authorized_official_title_or_position": "PRESIDENT, FULL MOON PHYSICIAN MGT",
        "authorized_official_telephone_number": "281-829-3999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "TX",
            "license": "K9440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Houston, TX
• Providers in Houston, TX by specialty
• Medical Specialty Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.