NPIMap

Organization Active NPI

Premier Provider Health PA

  • Infectious Disease Physician
  • Austin, TX
National Provider Identifier
1013397066
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
M0223 Issued in TX
Legal business name
PREMIER PROVIDER HEALTH PA
Practice address
4316 James Casey St Ste B-100
Austin, TX 78745-1142
Phone
(512) 444-4325
NPI assigned
Jun 4, 2015
Last updated
Jun 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Han Ngoc Pham, M.D.
Title
Ceo
Phone
(214) 274-1507

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X M0223 TX Primary

Addresses

Primary practice location

4316 James Casey St Ste B-100
Austin, TX 78745-1142

Mailing address

7314 Centenary Ave Ste 700
Dallas, TX 75225-4624
Phone (214) 274-1507

Other practice location 1

901 W Ben White Blvd
Austin, TX 78704
Phone (512) 816-7102

Other practice location 2

12221 N Mopac Expy
Austin, TX 78758-2401
Phone (512) 202-3830

Other practice location 3

12221 N Mopac Expy
Austin, TX 78758-2401
Phone (512) 202-3830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070615000236 TX Part B Supplier - Clinic/Group Practice 2264531276 Receives reassigned benefits from 41 practitioners
3 other NPIs on this enrollment
Practice locations: Fort Worth, TX; Tyler, TX; Tomball, TX; The Woodlands, TX; San Antonio, TX; Round Rock, TX; Pearsall, TX; Frisco, TX…

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1300 W Rosedale St
Ste A
Fort Worth, TX 76104
Phone (817) 377-4011

6161 State Highway 161
Ste 310
Irving, TX 75038
Phone (469) 697-6064

1128 Clarksville St
Ste 50
Paris, TX 75460
Phone (903) 739-7620

2410 Round Rock Ave
Ste 195
Round Rock, TX 78681
Phone (512) 341-5141

Practitioners & affiliated clinicians

Practitioners 41

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 41

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655769600000",
    "number": "1013397066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7314 CENTENARY AVE STE 700",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752254624",
            "telephone_number": "214-274-1507",
            "fax_number": "512-354-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4316 JAMES CASEY ST STE B-100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451142",
            "telephone_number": "512-444-4325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 W Ben White Blvd",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "78704",
            "country_code": "US",
            "telephone_number": "512-816-7102",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12221 N Mopac Expy",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787582401",
            "country_code": "US",
            "telephone_number": "512-202-3830",
            "fax_number": "512-354-1106",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12221 N Mopac Expy",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787582401",
            "country_code": "US",
            "telephone_number": "512-202-3830",
            "fax_number": "512-354-1106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PREMIER PROVIDER HEALTH PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-04",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "HAN",
        "authorized_official_middle_name": "NGOC",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-274-1507",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TX",
            "license": "M0223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.