Provider Demographics
NPI:1366638538
Name:PHAM, NHI LAN (MD)
Entity Type:Individual
Prefix:MRS
First Name:NHI
Middle Name:LAN
Last Name:PHAM
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 1:111 DALLAS STREET
Mailing Address - Street 2:BAPTIST MEDICAL CENTER - HOSPITALIST OFFICE
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-1240
Mailing Address - Country:US
Mailing Address - Phone:210-297-6000
Mailing Address - Fax:
Practice Address - Street 1:111 DALLAS ST
Practice Address - Street 2:HOSPITALIST OFFICE
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-1201
Practice Address - Country:US
Practice Address - Phone:210-297-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-20
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL939475207R00000X
TXM8250207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1366638538OtherSCOTT & WHITE HEALTH PLAN
TXP00471688OtherRR MEDICARE
8AN223OtherBC/BS
TX190584601Medicaid
TXP00471688Medicare PIN
TX8K0887Medicare PIN