Provider Demographics
NPI:1679014914
Name:PHAM, DIEM HUONG (MD)
Entity type:Individual
Prefix:
First Name:DIEM HUONG
Middle Name:
Last Name:PHAM
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8133 MESA DR STE 104
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8655
Mailing Address - Country:US
Mailing Address - Phone:512-522-7399
Mailing Address - Fax:865-263-3787
Practice Address - Street 1:8133 MESA DR STE 104
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8655
Practice Address - Country:US
Practice Address - Phone:512-522-7399
Practice Address - Fax:865-263-3787
Is Sole Proprietor?:No
Enumeration Date:2017-03-20
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
LA390200000X
TXT22432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program