MEDICARE: LINDA HOANG PHAM D.C.

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	111N00000X	Chiropractor	12396	TX

General Provider Information

NPI Number	:	1508206897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA HOANG PHAM D.C.

Provider Business Mailing Address
First Line	:	3015 SOUTH FWY
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-7234
Country	:	US
Telephone Number	:	817-926-2288
Fax Number	:	817-926-4080

Provider Business Practice Location Address
First Line	:	3015 SOUTH FWY
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-7234
Country	:	US
Telephone Number	:	817-926-2288
Fax Number	:	817-926-4080

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

Provider Enumeration Date	:	07/01/2013
Last Update Date	:	10/24/2014

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