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NPI Code Detail

MEDICARE: TAM PHAM

MEDICARE: TAM PHAM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist21158OK

General Provider Information

NPI Number : 1124985569
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAM PHAM
Provider Business Mailing Address
First Line : 13503 S SANTA FE AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73170-7314
Country : US
Telephone Number : 405-300-6418
Fax Number : 405-300-6417
Provider Business Practice Location Address
First Line : 13503 S SANTA FE AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73170-7314
Country : US
Telephone Number : 405-300-6418
Fax Number : 405-300-6417
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2026
Last Update Date : 01/07/2026

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Directions to “ TAM PHAM ” Practice Location

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