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NPI Code Detail

MEDICARE: DR. MIMI PHAN M.D.

MEDICARE: DR. MIMI PHAN M.D.
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
1207R00000XInternal Medicine PhysicianBP10038072TX
2207RP1001XPulmonary Disease PhysicianP7537TX

General Provider Information

NPI Number : 1093035610
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MIMI PHAN M.D.
Provider Business Mailing Address
First Line : 13219 DOTSON RD STE 210
Second Line :
City : HOUSTON
State : TX
Zip : 77070-4308
Country : US
Telephone Number : 281-955-0338
Fax Number : 281-469-0741
Provider Business Practice Location Address
First Line : 13219 DOTSON RD STE 210
Second Line :
City : HOUSTON
State : TX
Zip : 77070-4308
Country : US
Telephone Number : 281-955-0338
Fax Number : 281-469-0741
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2010
Last Update Date : 06/24/2024

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Directions to “ DR. MIMI PHAN M.D.” Practice Location

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