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NPI Code Detail

MEDICARE: MISS YVETTE ANN PHAM LMT

MEDICARE:  MISS YVETTE ANN PHAM  LMT
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
1174400000XSpecialistMT 112783TX

General Provider Information

NPI Number : 1043502438
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS YVETTE ANN PHAM LMT
Provider Business Mailing Address
First Line : 2150 TRAWOOD DR
Second Line : SUITE B250-1
City : EL PASO
State : TX
Zip : 79935-3322
Country : US
Telephone Number : 915-603-4102
Fax Number :
Provider Business Practice Location Address
First Line : 2150 TRAWOOD DR
Second Line : SUITE B250-1
City : EL PASO
State : TX
Zip : 79935-3322
Country : US
Telephone Number : 915-603-4102
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2011
Last Update Date : 05/04/2011

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Directions to “ MISS YVETTE ANN PHAM LMT” Practice Location

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