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General NPI Number Information
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NPI Number | 1932734936
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Entity Type | Organization
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Legal Business Name | QNPHAM, PLLC
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Dates
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Enumeration Date | 03/10/2020
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Last Update Date | 03/10/2020
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Provider Practice Location Address
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Address Line | 4940 W. UNIVERSITY DR
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City | PROSPER
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State | TX
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Zip | 75078
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Country | US
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Telephone | 817-808-2463
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Fax |
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Provider Business Mailing Address
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Address Line | 5301 ALTA VISTA LN
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City | ARLINGTON
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State | TX
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Zip | 76017-1735
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | QUYNH NHI PHAM
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Credential | O.D.
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Telephone | 817-808-2463
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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 |
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License Number State |
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