MEDICARE: DARREN PHAM OD

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
1	152W00000X	Optometrist	9784TG	TX

General Provider Information

NPI Number	:	1235779885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARREN PHAM OD

Provider Business Mailing Address
First Line	:	425 COIT RD
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75075-5709
Country	:	US
Telephone Number	:	972-664-4844
Fax Number	:	972-664-4844

Provider Business Practice Location Address
First Line	:	425 COIT RD
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75075-5709
Country	:	US
Telephone Number	:	972-664-4844
Fax Number	:	972-664-4844

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2020
Last Update Date	:	07/30/2025

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Directions to “ DARREN PHAM OD” Practice Location

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