MEDICARE: NORTHERN PINES HEALTH PARTNERS PA

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	207R00000X	Internal Medicine Physician	L9848	TX
2	207Q00000X	Family Medicine Physician	M6312	TX

General Provider Information

NPI Number	:	1134322233
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHERN PINES HEALTH PARTNERS PA

Provider Business Mailing Address
First Line	:	8515 SPRING CYPRESS RD
Second Line	:	SUITE #108
City	:	SPRING
State	:	TX
Zip	:	77379-3354
Country	:	US
Telephone Number	:	281-376-2200
Fax Number	:	281-376-2205

Provider Business Practice Location Address
First Line	:	8515 SPRING CYPRESS RD
Second Line	:	#108
City	:	SPRING
State	:	TX
Zip	:	77379-3354
Country	:	US
Telephone Number	:	281-376-2200
Fax Number	:	281-376-2205

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. NGUYEN DUC PHAN
Credential	:	MD
Telephone Number	:	281-376-2200

Provider Enumeration Date	:	06/06/2007
Last Update Date	:	07/10/2008

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Practice Location Address:

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Directions to “NORTHERN PINES HEALTH PARTNERS PA ” Practice Location

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