Provider Demographics
NPI:1508326000
Name:LAC ANH.,PA
Entity Type:Organization
Organization Name:LAC ANH.,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HOANG-ANH
Authorized Official - Middle Name:LAC
Authorized Official - Last Name:PHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:713-437-7114
Mailing Address - Street 1:4906 IVORY MEADOWS LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-3991
Mailing Address - Country:US
Mailing Address - Phone:713-437-7114
Mailing Address - Fax:
Practice Address - Street 1:8208 GULF FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77017-4530
Practice Address - Country:US
Practice Address - Phone:832-820-6160
Practice Address - Fax:832-810-6162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-21
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty