Healthcare Provider Details

I. General information

NPI: 1932501889
Provider Name (Legal Business Name): TRAUMA AND GENERAL SURGEONS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2014
Last Update Date: 01/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 N TEXAS AVE SUITE A-2
WEBSTER TX
77598-4959
US

IV. Provider business mailing address

PO BOX 58534
WEBSTER TX
77598-8534
US

V. Phone/Fax

Practice location:
  • Phone: 281-616-6017
  • Fax: 281-947-3037
Mailing address:
  • Phone: 281-616-6017
  • Fax: 281-947-3037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP125135
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HOANG Q PHAM
Title or Position: PRESIDENT
Credential: MD
Phone: 281-616-6017