MEDICARE: DR. TU MINH PHAM D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	6613	TX

General Provider Information

NPI Number	:	1003828914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TU MINH PHAM D.O.

Provider Business Mailing Address
First Line	:	13433 STATE HIGHWAY 249
Second Line	:	SUITE #9
City	:	HOUSTON
State	:	TX
Zip	:	77086-3169
Country	:	US
Telephone Number	:	281-272-2555
Fax Number	:	281-272-2556

Provider Business Practice Location Address
First Line	:	13433 STATE HIGHWAY 249
Second Line	:	SUITE #9
City	:	HOUSTON
State	:	TX
Zip	:	77086-3169
Country	:	US
Telephone Number	:	281-272-2555
Fax Number	:	281-272-2556

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	05/06/2008

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