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General NPI Number Information
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NPI Number | 1649775925
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Entity Type | Individual
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Provider Name | HIEU MITCHELL DUC PHAM MD
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Gender | Male
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Dates
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Enumeration Date | 03/28/2018
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Last Update Date | 05/21/2024
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Provider Practice Location Address
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Address Line | 2000 W 15TH ST
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City | PLANO
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State | TX
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Zip | 75075-7331
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Country | US
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Telephone | 972-612-9000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 863898
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City | PLANO
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State | TX
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Zip | 75086-3898
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Country | US
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Telephone | 469-939-0372
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | E-15236
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License Number State | AR
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