Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | BP10032655 | TX |
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | P5560 | TX |
NPI | 1053570184 |
---|---|
Provider Name | Dr. Viet Hoai Pham |
First Address | San Antonio, TX 78229 |
Second Address | San Antonio, TX 78229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2008 |
Last Update Date | 24/06/2013 |