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NPI Code Detail

MEDICARE: STEPHANIE PHAM

MEDICARE:   STEPHANIE  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
1246Z00000XOther Specialist/Technologist

General Provider Information

NPI Number : 1801628698
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE PHAM
Provider Business Mailing Address
First Line : 1235 NASA PKWY APT 1471
Second Line :
City : HOUSTON
State : TX
Zip : 77058-3379
Country : US
Telephone Number : 801-309-9249
Fax Number :
Provider Business Practice Location Address
First Line : 4665 SOUTHWEST FWY # 212
Second Line :
City : HOUSTON
State : TX
Zip : 77027-7213
Country : US
Telephone Number : 832-930-1212
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2024
Last Update Date : 08/19/2024

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Directions to “ STEPHANIE PHAM ” Practice Location

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