Provider Demographics
NPI:1679619134
Name:PHAM, HUY QUANG (MD)
Entity Type:Individual
Prefix:DR
First Name:HUY
Middle Name:QUANG
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 840853
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0853
Mailing Address - Country:US
Mailing Address - Phone:972-233-1999
Mailing Address - Fax:972-233-3666
Practice Address - Street 1:1500 CITYWEST BLVD
Practice Address - Street 2:STE. 300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042
Practice Address - Country:US
Practice Address - Phone:713-620-4000
Practice Address - Fax:713-458-4229
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5180207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX050059384OtherRAILROAD - MEDCIARE
TX8AW231OtherBLUE CROSS BLUE SHIELD
TX8014J9OtherOUT HARRIS - MEDICARE
TX038645001Medicaid
81311KOtherTX-BLUE SHIELD
TX038645002Medicaid
LA1589446OtherLA - MEDICAID
TX8014J9OtherOUT HARRIS - MEDICARE
TX8AW231OtherBLUE CROSS BLUE SHIELD
LA1589446OtherLA - MEDICAID