Healthcare Provider Details

I. General information

NPI: 1407304066
Provider Name (Legal Business Name): HAN PHAM HULEN MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2016
Last Update Date: 09/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18960 N MEMORIAL DR PLAZA 4
HUMBLE TX
77338-4216
US

IV. Provider business mailing address

PO BOX 842193
DALLAS TX
75284-2193
US

V. Phone/Fax

Practice location:
  • Phone: 281-540-6322
  • Fax: 281-540-7107
Mailing address:
  • Phone: 512-202-3830
  • Fax: 512-354-1106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: HAN HULEN
Title or Position: MD; OWNER
Credential: MD
Phone: 972-566-4868