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General NPI Number Information
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NPI Number | 1508190711
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Entity Type | Individual
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Provider Name | BARI M PHAM AUD
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Gender | Female
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Dates
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Enumeration Date | 09/22/2009
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Last Update Date | 09/22/2009
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Provider Practice Location Address
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Address Line | 750 MID CITIES BLVD STE 100 AND 130
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City | HURST
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State | TX
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Zip | 76054-2792
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Country | US
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Telephone | 817-581-2794
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Fax | 817-656-3659
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Provider Business Mailing Address
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Address Line | PO BOX 99213
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City | FORT WORTH
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State | TX
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Zip | 76199-0213
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Country | US
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Telephone | 682-885-4432
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Fax | 682-885-3936
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 51551
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License Number State | TX
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