Provider Demographics
NPI:1437255668
Name:PHAM, HAI X (DDS)
Entity Type:Individual
Prefix:DR
First Name:HAI
Middle Name:X
Last Name:PHAM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8436 DENTON HWY
Mailing Address - Street 2:SUITE 218
Mailing Address - City:WATAUGA
Mailing Address - State:TX
Mailing Address - Zip Code:76148-2472
Mailing Address - Country:US
Mailing Address - Phone:817-605-3551
Mailing Address - Fax:817-605-1344
Practice Address - Street 1:8436 DENTON HWY
Practice Address - Street 2:SUITE 218
Practice Address - City:WATAUGA
Practice Address - State:TX
Practice Address - Zip Code:76148-2472
Practice Address - Country:US
Practice Address - Phone:817-605-3551
Practice Address - Fax:817-605-1344
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX181451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice