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General NPI Number Information
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NPI Number | 1629173000
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Entity Type | Organization
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Legal Business Name | DR NINH PHAM OD AND ASSOCIATES
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 07/21/2008
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Provider Practice Location Address
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Address Line | 9025 SPENCER HWY DR. NINH PHAM'S OPTOMETRY OFFICE
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City | LA PORTE
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State | TX
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Zip | 77571-3870
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Country | US
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Telephone | 281-542-9350
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Fax | 281-542-9355
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Provider Business Mailing Address
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Address Line | 3919 FAIRMONT PKWY APT 220
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City | PASADENA
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State | TX
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Zip | 77504-3063
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Country | US
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Telephone | 281-542-9350
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. NINH XUAN PHAM
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Credential | O.D.
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Telephone | 281-542-9350
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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 | 6245TG
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License Number State | TX
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