MEDICARE: THUYTRANG T PHAM

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	363LF0000X	Family Nurse Practitioner	1228884	TX

General Provider Information

NPI Number	:	1306792478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THUYTRANG T PHAM

Provider Business Mailing Address
First Line	:	221 SADDLEBROOK DR
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75044-5071
Country	:	US
Telephone Number	:	816-582-2868
Fax Number	:

Provider Business Practice Location Address
First Line	:	221 SADDLEBROOK DR
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75044-5071
Country	:	US
Telephone Number	:	816-582-2868
Fax Number	:

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

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	03/10/2026

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Directions to “ THUYTRANG T PHAM ” Practice Location

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