Individual provider Active NPI

Victoria Phan, MD

  • Obstetrics & Gynecology Physician
  • Frisco, TX
National Provider Identifier
1104484989
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
U6049 Issued in TX
Practice address
5680 Frisco Square Blvd Ste 2700
Frisco, TX 75034-3316
Phone
(972) 668-8300
NPI assigned
Jun 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X BP10068734 TX
Obstetrics & Gynecology Physician 207V00000X U6049 TX Primary

Addresses

Primary practice location

5680 Frisco Square Blvd Ste 2700
Frisco, TX 75034-3316

Mailing address

5680 Frisco Square Blvd Ste 2700
Frisco, TX 75034-3316

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230927003184 TX Practitioner - Obstetrics/Gynecology 0749517373 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
BP10068734TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Randall Burt MD PA Current Accepting new patients
Steven R. Macdonald, M.D., P.a. Current Accepting new patients
Unified Women'S Healthcare of Texas PLLC Obstetrics & Gynecology CurrentSince Sep 13, 2023 Accepting new patients

Locations

5680 Frisco Square Blvd
Ste 2700
Frisco, TX 75034
Phone (469) 283-0143

6124 W Parker Rd
Ste 134
Plano, TX 75093
Phone (972) 981-7777

Interoperability endpoints

  • Direct secure messaging: victoria.phan.1@11541.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1104484989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5680 FRISCO SQUARE BLVD STE 2700",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750343316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5680 FRISCO SQUARE BLVD STE 2700",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750343316",
            "telephone_number": "972-668-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "VICTORIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2023-08-07",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10068734",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "U6049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.