Provider Demographics
NPI:1811025141
Name:PHAM, DUNG (DC)
Entity Type:Individual
Prefix:DR
First Name:DUNG
Middle Name:
Last Name:PHAM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15003 F.M. 529
Mailing Address - Street 2:SUITE F
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-3247
Mailing Address - Country:US
Mailing Address - Phone:281-855-0200
Mailing Address - Fax:281-855-0611
Practice Address - Street 1:15003 F.M. 529
Practice Address - Street 2:SUITE F
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-3247
Practice Address - Country:US
Practice Address - Phone:281-855-0200
Practice Address - Fax:281-855-0611
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9327111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician