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General NPI Number Information
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NPI Number | 1558728105
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Entity Type | Organization
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Legal Business Name | VICTORIA GLICKMAN-PHAM,O.D.,PLLC
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Dates
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Enumeration Date | 01/26/2016
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Last Update Date | 01/27/2016
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Provider Practice Location Address
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Address Line | 13147 NORTHWEST FWY SUITE 100
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City | HOUSTON
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State | TX
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Zip | 77040-6397
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Country | US
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Telephone | 713-462-2010
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Fax | 713-460-3898
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Provider Business Mailing Address
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Address Line | 13147 NORTHWEST FWY SUITE 100
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City | HOUSTON
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State | TX
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Zip | 77040-6397
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Country | US
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Telephone | 713-462-2010
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Fax | 713-460-3898
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Authorized Official
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Title or Position | OWNER
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Name | DR. VICTORIA GLICKMAN-PHAM
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Credential | OD
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Telephone | 713-462-2010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 7522TG
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License Number State | TX
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