Provider Demographics
NPI:1235177098
Name:HUYNH, TAM THI THANH (MD)
Entity Type:Individual
Prefix:
First Name:TAM
Middle Name:THI THANH
Last Name:HUYNH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18400 KATY FREEWAY
Mailing Address - Street 2:MEDICAL OFFICE BLDG, SUITE 640
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77094
Mailing Address - Country:US
Mailing Address - Phone:832-522-8600
Mailing Address - Fax:832-522-8601
Practice Address - Street 1:18400 KATY FWY
Practice Address - Street 2:MEDICAL OFFICE BLDG, SUITE 640
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77094
Practice Address - Country:US
Practice Address - Phone:832-522-8600
Practice Address - Fax:832-522-8601
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC870282086S0129X
TXL02862086S0129X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX037257504Medicaid
TX037257506Medicaid
TX037257503Medicaid
TX1235177098OtherBLUE CROSS BLUE SHIELD
TX037257507Medicaid
H24851Medicare UPIN
TXTXB119629Medicare PIN
8G3168Medicare PIN
TX037257506Medicaid
TX037257503Medicaid
TXP00738078Medicare PIN