Provider Demographics
NPI:1871040824
Name:PHAM, ANH TUAN (DDS)
Entity Type:Individual
Prefix:
First Name:ANH
Middle Name:TUAN
Last Name:PHAM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 S MASON RD STE 104
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-6268
Mailing Address - Country:US
Mailing Address - Phone:281-394-0999
Mailing Address - Fax:281-394-1999
Practice Address - Street 1:2300 S MASON RD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-6267
Practice Address - Country:US
Practice Address - Phone:281-879-7749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-07
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32377122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist