Provider Demographics
NPI:1003828914
Name:PHAM, TU MINH (DO)
Entity Type:Individual
Prefix:DR
First Name:TU
Middle Name:MINH
Last Name:PHAM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:13433 STATE HIGHWAY 249
Mailing Address - Street 2:SUITE #9
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77086-3169
Mailing Address - Country:US
Mailing Address - Phone:281-272-2555
Mailing Address - Fax:281-272-2556
Practice Address - Street 1:13433 STATE HIGHWAY 249
Practice Address - Street 2:SUITE #9
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77086-3169
Practice Address - Country:US
Practice Address - Phone:281-272-2555
Practice Address - Fax:281-272-2556
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX6613152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F2715Medicare PIN
TXV04559Medicare UPIN