Provider Demographics
NPI:1003850033
Name:PHAM, CHI M (MD)
Entity type:Individual
Prefix:DR
First Name:CHI
Middle Name:M
Last Name:PHAM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12303 WESTHEIMER RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-6003
Mailing Address - Country:US
Mailing Address - Phone:281-556-5823
Mailing Address - Fax:281-556-5060
Practice Address - Street 1:12303 WESTHEIMER RD
Practice Address - Street 2:STE B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-6059
Practice Address - Country:US
Practice Address - Phone:281-556-5823
Practice Address - Fax:281-556-5060
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2016-12-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXG1993173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX033924401Medicaid
TXHU23OtherBCBS
TXC20478Medicare UPIN
TXHU23OtherBCBS