Provider Demographics
NPI:1811367451
Name:PHAM, TRAM (PA-C)
Entity type:Individual
Prefix:
First Name:TRAM
Middle Name:
Last Name:PHAM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:3066 E COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78220-1013
Mailing Address - Country:US
Mailing Address - Phone:210-233-7647
Mailing Address - Fax:210-228-0065
Practice Address - Street 1:3619 PAESANOS PKWY STE 212
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78231-1255
Practice Address - Country:US
Practice Address - Phone:210-233-7000
Practice Address - Fax:210-690-5595
Is Sole Proprietor?:No
Enumeration Date:2015-09-25
Last Update Date:2018-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX593868363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical