MEDICARE: HAN PHAM HULEN MD PA

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1407304066
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAN PHAM HULEN MD PA

Provider Business Mailing Address
First Line	:	PO BOX 842193
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-2193
Country	:	US
Telephone Number	:	512-202-3830
Fax Number	:	512-354-1106

Provider Business Practice Location Address
First Line	:	18960 N MEMORIAL DR
Second Line	:	PLAZA 4
City	:	HUMBLE
State	:	TX
Zip	:	77338-4216
Country	:	US
Telephone Number	:	281-540-6322
Fax Number	:	281-540-7107

Authorized Official
Title or Position	:	MD; OWNER
Name	:	HAN HULEN
Credential	:	MD
Telephone Number	:	972-566-4868

Provider Enumeration Date	:	09/13/2016
Last Update Date	:	09/13/2016

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