MEDICARE: MS. ANGELA PHAM LPC

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	101YP2500X	Professional Counselor	71854	TX

General Provider Information

NPI Number	:	1336679216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANGELA PHAM LPC

Provider Business Mailing Address
First Line	:	11011 RICHMOND AVE STE 350
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-6790
Country	:	US
Telephone Number	:	281-624-6211
Fax Number	:

Provider Business Practice Location Address
First Line	:	11011 RICHMOND AVE STE 350
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-6790
Country	:	US
Telephone Number	:	281-624-6211
Fax Number	:

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

Provider Enumeration Date	:	06/14/2017
Last Update Date	:	07/21/2022

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