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General NPI Number Information
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NPI Number | 1780948737
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Entity Type | Individual
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Provider Name | TAM DAN NGUYEN PHAM M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/25/2012
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Last Update Date | 04/08/2019
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Provider Practice Location Address
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Address Line | 6651 MAIN ST FL 19
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City | HOUSTON
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State | TX
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Zip | 77030-2351
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Country | US
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Telephone | 713-444-6989
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Fax |
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Provider Business Mailing Address
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Address Line | 821 W 22ND ST
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City | HOUSTON
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State | TX
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Zip | 77008-1729
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Country | US
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Telephone | 713-444-6989
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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 | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | 262701
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | S1224
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License Number State | TX
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