Healthcare Provider Details

I. General information

NPI: 1699304964
Provider Name (Legal Business Name): CHRISTINE GE PHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2020
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6431 FANNIN ST STE MSB 3151
HOUSTON TX
77030-1501
US

IV. Provider business mailing address

6431 FANNIN ST STE MSB 3151
HOUSTON TX
77030-1501
US

V. Phone/Fax

Practice location:
  • Phone: 713-500-5800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberU2977
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: