Provider Demographics
NPI:1912342908
Name:PHAM, NGOC (MD)
Entity Type:Individual
Prefix:DR
First Name:NGOC
Middle Name:
Last Name:PHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 FROSTWOOD DR STE 315
Mailing Address - Street 2:ATTENTION: CREDENTIALING
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2424
Mailing Address - Country:US
Mailing Address - Phone:713-827-1231
Mailing Address - Fax:713-827-1380
Practice Address - Street 1:10405 KATY FWY STE 150E
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1165
Practice Address - Country:US
Practice Address - Phone:713-722-9660
Practice Address - Fax:713-722-9664
Is Sole Proprietor?:No
Enumeration Date:2013-05-03
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ90042085R0001X, 2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX386288003Medicaid