Provider Demographics
NPI:1831374388
Name:PHAM, LINH MY (WHCNP)
Entity type:Individual
Prefix:
First Name:LINH
Middle Name:MY
Last Name:PHAM
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 660599
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-0599
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:802 HOPKINS ST
Practice Address - Street 2:GARLAND WOMEN'S HEALTH CENTER
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-7379
Practice Address - Country:US
Practice Address - Phone:214-266-0780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-03
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX659145363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX193984502Medicaid
TX193984507Medicaid
TX193984510Medicaid
TX193984505Medicaid
TX8Y3497OtherBLUE CROSS BLUE SHIELD
TX193984504Medicaid
TX193984506Medicaid
TX193984501Medicaid
TX193984503Medicaid
TX193984508Medicaid
TX193984509Medicaid