Provider Demographics
NPI:1558371559
Name:PHAM, BINH V (MD)
Entity Type:Individual
Prefix:
First Name:BINH
Middle Name:V
Last Name:PHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10597
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78766-1597
Mailing Address - Country:US
Mailing Address - Phone:512-420-0186
Mailing Address - Fax:512-420-0397
Practice Address - Street 1:7951 SHOAL CREEK BLVD STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-7581
Practice Address - Country:US
Practice Address - Phone:512-454-5888
Practice Address - Fax:512-459-9869
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA96488207RG0100X
TXN7478207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2183501-01Medicaid
TX8CN821OtherBCBS IND. NUMBER
TXTXB115939Medicare PIN