Doctor Name: | TRONG QUANG PHAM |
NPI Number: | 1629369020 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 23097 |
Business Practice Address: | 207 S Houston St Ste 400 Dallas, TX - 752024799 |
Business Phone Number: | 2146553210 |
Business Fax Number: | 2146553212 |
Mailing Address: | 207 S Houston St Ste 400, DALLAS |
State: | TX |
Postal Code: | 752024799 |
Phone Number: | 2146553210 |
Fax Number: | 2146553212 |
NPI Enumeration Date: | 04/20/2011 |
NPI Last Update Date: | 04/20/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 23097 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |