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General NPI Number Information
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NPI Number | 1245851492
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Entity Type | Individual
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Provider Name | GINA NHU PHAM
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Gender | Female
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Dates
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Enumeration Date | 04/29/2020
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 712 N WASHINGTON AVE STE 415
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City | DALLAS
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State | TX
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Zip | 75246-1634
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Country | US
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Telephone | 214-826-7231
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Fax | 214-826-7984
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Provider Business Mailing Address
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Address Line | 712 N WASHINGTON AVE STE 415
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City | DALLAS
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State | TX
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Zip | 75246-1634
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | V2218
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License Number State | TX
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