Provider Demographics
NPI:1003839754
Name:PHAM, HIEN D (MD)
Entity Type:Individual
Prefix:DR
First Name:HIEN
Middle Name:D
Last Name:PHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 392556
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-9556
Mailing Address - Country:US
Mailing Address - Phone:713-806-1855
Mailing Address - Fax:888-889-2522
Practice Address - Street 1:3640 HAMPTON DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459
Practice Address - Country:US
Practice Address - Phone:713-806-1855
Practice Address - Fax:888-889-2522
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8918208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX217378301Medicaid
TX217378301Medicaid