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General NPI Number Information
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NPI Number | 1407020035
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Entity Type | Individual
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Provider Name | HOANG-ANH LAC PHAN D.O
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Gender | Female
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Dates
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Enumeration Date | 04/15/2008
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 12000 BELLAIRE BLVD STE 140
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City | HOUSTON
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State | TX
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Zip | 77072-2577
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Country | US
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Telephone | 832-644-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 4906 IVORY MEADOWS LN
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City | HOUSTON
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State | TX
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Zip | 77084-3991
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Country | US
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Telephone | 281-919-8050
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | M9579
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | M9579
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License Number State | TX
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