Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 10018 | TX |
NPI | 1003420126 |
---|---|
Provider Name | Anna Hoai Pham |
First Address | Pflugerville, TX 78660-8811 |
Second Address | San Antonio, TX 78245-4012 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2020 |
Last Update Date | 04/09/2020 |