Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NR0400X | Rehabilitation Chiropractor | 6746 | TX |
Y | 111NX0100X | Occupational Health | 6746 | TX |
NPI | 1730234170 |
---|---|
Provider Name | Dr. Quan D Pham |
First Address | Richardson, TX 75081-4034 |
Second Address | Richardson, TX 75081-4034 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 03/10/2013 |