Provider Demographics
NPI:1013410935
Name:HO-PHAM, THY THANH
Entity Type:Individual
Prefix:
First Name:THY
Middle Name:THANH
Last Name:HO-PHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 NORTH LOOP W STE 300
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-8915
Mailing Address - Country:US
Mailing Address - Phone:713-758-9102
Mailing Address - Fax:
Practice Address - Street 1:2600 NORTH LOOP W STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-8915
Practice Address - Country:US
Practice Address - Phone:713-758-9102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-16
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator