Healthcare Provider Details

I. General information

NPI: 1245146729
Provider Name (Legal Business Name): AN MINH PHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2409 UNIVERSITY AVE
AUSTIN TX
78712-1112
US

IV. Provider business mailing address

5715 AMES XING
SUGAR LAND TX
77479-8910
US

V. Phone/Fax

Practice location:
  • Phone: 512-417-1737
  • Fax:
Mailing address:
  • Phone: 832-396-6883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: