Provider Demographics
NPI:1689647968
Name:PHAM, HIEN QUANG (MD)
Entity Type:Individual
Prefix:DR
First Name:HIEN
Middle Name:QUANG
Last Name:PHAM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2021 N MACARTHUR BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-2219
Mailing Address - Country:US
Mailing Address - Phone:972-253-2560
Mailing Address - Fax:972-253-4218
Practice Address - Street 1:6750 N MACARTHUR BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-2875
Practice Address - Country:US
Practice Address - Phone:972-401-2802
Practice Address - Fax:972-401-0458
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2017-03-02
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Provider Licenses
StateLicense IDTaxonomies
TXK0540207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1335754 12Medicaid
TX1335754 12Medicaid
TX00103MMedicare PIN
TXG42384Medicare UPIN