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NPI Code Detail

MEDICARE: DR. QUANG PHAM

MEDICARE: DR. QUANG 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
1152W00000XOptometrist06290TGTX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598890337
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. QUANG PHAM
Provider Business Mailing Address
First Line : 16019 NACOGDOCHES RD STE 112
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78247-1128
Country : US
Telephone Number : 210-659-2955
Fax Number : 210-787-3410
Provider Business Practice Location Address
First Line : 16019 NACOGDOCHES RD STE 112
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78247-1128
Country : US
Telephone Number : 210-659-2955
Fax Number : 210-787-3410
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2007
Last Update Date : 06/12/2024

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Directions to “ DR. QUANG PHAM ” Practice Location

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