Provider Demographics
NPI:1720679038
Name:HAN PHAM HULEN MD PA
Entity Type:Organization
Organization Name:HAN PHAM HULEN MD PA
Other - Org Name:WOUND EVOLUTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD; OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PHAM HULEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-274-1507
Mailing Address - Street 1:PO BOX 3409
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78691-3409
Mailing Address - Country:US
Mailing Address - Phone:513-252-7792
Mailing Address - Fax:513-904-5908
Practice Address - Street 1:9150 HUEBNER RD STE 120
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1545
Practice Address - Country:US
Practice Address - Phone:210-334-0012
Practice Address - Fax:210-334-0196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-29
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty