Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081P2900X | Pain Medicine | DO.000032 | LA |
Y | 2081P2900X | Pain Medicine | M8917 | TX |
NPI | 1215138714 |
---|---|
Provider Name | Dr. Anthony Tam Pham |
First Address | Houston, TX 77025-1405 |
Second Address | Waller, TX 77484-8743 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2007 |
Last Update Date | 07/04/2008 |