Provider Demographics
NPI:1225412554
Name:VO-PHAM, NATALIE-UYEN (DMD)
Entity Type:Individual
Prefix:
First Name:NATALIE-UYEN
Middle Name:
Last Name:VO-PHAM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5509 SW 9TH AVE
Mailing Address - Street 2:APT # 615
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-4172
Mailing Address - Country:US
Mailing Address - Phone:858-349-0845
Mailing Address - Fax:
Practice Address - Street 1:2100 S DUMAS AVE
Practice Address - Street 2:STE 112
Practice Address - City:DUMAS
Practice Address - State:TX
Practice Address - Zip Code:79029-6102
Practice Address - Country:US
Practice Address - Phone:806-934-3170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX311511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice