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NPI Code Detail

MEDICARE: ANNIE PHAM

MEDICARE: ANNIE 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
1246ZE0600XElectroneurodiagnostic Specialist/TechnologistTX

General Provider Information

NPI Number : 1841849940
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNIE PHAM
Provider Business Mailing Address
First Line : 1720 WINCHESTER WAY
Second Line :
City : BEDFORD
State : TX
Zip : 76022-6813
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 16633 DALLAS PKWY STE 150
Second Line :
City : ADDISON
State : TX
Zip : 75001-6812
Country : US
Telephone Number : 972-380-0000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2019
Last Update Date : 09/11/2019

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Directions to “ ANNIE PHAM ” Practice Location

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