Physician Compare National (NPI:1407020035)

HEALTHCARE PROVIDER: HOANG-ANH LAC PHAN D.O

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1407020035
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2466690094
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20141105000114
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PHAN
	Individual professional last name
Provider First Name	HOANG-ANH
	Individual professional first name
Provider Middle Name	L
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2006
	Individual professional's medical school graduation year
Primary Specialty	HOSPITALIST
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	9814 GRANT RD
	Group Practice or individual's line 1 address
City	HOUSTON
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	770704558
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450844
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HOUSTON METHODIST WILLOWBROOK HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450610
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MEMORIAL HERMANN MEMORIAL CITY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y