Provider Demographics
NPI:1598938425
Name:BICH-NGOC THI PHAM, MD, LLC
Entity Type:Organization
Organization Name:BICH-NGOC THI PHAM, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BICH-NGOC
Authorized Official - Middle Name:THI
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-341-1191
Mailing Address - Street 1:PO BOX 2367
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70073-2367
Mailing Address - Country:US
Mailing Address - Phone:504-341-1191
Mailing Address - Fax:504-371-4703
Practice Address - Street 1:1301 BARATARIA BLVD
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-3703
Practice Address - Country:US
Practice Address - Phone:504-341-1191
Practice Address - Fax:504-371-4703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA024591207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty