Provider Demographics
NPI:1821722034
Name:PHAM, ZOE LY (OD)
Entity Type:Individual
Prefix:
First Name:ZOE
Middle Name:LY
Last Name:PHAM
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10510 PLEASANT VILLAS LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77075-3058
Mailing Address - Country:US
Mailing Address - Phone:832-620-7545
Mailing Address - Fax:
Practice Address - Street 1:19801 GULF FWY STE 900B
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-3824
Practice Address - Country:US
Practice Address - Phone:281-724-6150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-13
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10654T152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision