MEDICARE: DR. TOMMY THANH NHAN PHAM DC

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	111NI0013X	Independent Medical Examiner Chiropractor	15325	TX

General Provider Information

NPI Number	:	1891412136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TOMMY THANH NHAN PHAM DC

Provider Business Mailing Address
First Line	:	3339 LOMBARDY LN APT 929
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75220-3357
Country	:	US
Telephone Number	:	504-613-7574
Fax Number	:

Provider Business Practice Location Address
First Line	:	3339 LOMBARDY LN APT 929
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75220-3357
Country	:	US
Telephone Number	:	504-613-7574
Fax Number	:

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

Provider Enumeration Date	:	10/27/2022
Last Update Date	:	10/27/2022

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