Provider Demographics
NPI:1073019410
Name:PHAM, GIA HAN NGOC (DO)
Entity Type:Individual
Prefix:DR
First Name:GIA HAN
Middle Name:NGOC
Last Name:PHAM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:GIAHAN
Other - Middle Name:NGOC
Other - Last Name:PHAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO CANDIDATE
Mailing Address - Street 1:10651 E ST BLDG H100
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78419-5131
Mailing Address - Country:US
Mailing Address - Phone:361-961-6000
Mailing Address - Fax:
Practice Address - Street 1:10651 E ST BLDG H100
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78419-5130
Practice Address - Country:US
Practice Address - Phone:361-961-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS3441207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine