Individual provider Active NPI

Dang Pham, M.D.

  • Diagnostic Radiology Physician
  • Houston, TX
National Provider Identifier
1104807528
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
K3393 Issued in TX
Practice address
16750 Red Oak Dr
Houston, TX 77090-2543
Phone
(281) 453-7110
Fax
(281) 440-2020
NPI assigned
Nov 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X K3393 TX Primary

Addresses

Primary practice location

16750 Red Oak Dr
Houston, TX 77090-2543

Mailing address

3010 Palmer Way
Spring, TX 77380-4081
Phone (832) 930-8890

Other identifiers 2

IdentifierTypeStateIssuer
116256205MedicaidTX
116256204MedicaidTX

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
I20060509000870 TX Practitioner - Diagnostic Radiology 7618994575 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Medical Branch at Galveston, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Springwood Radiology Associates, PLLCGroup PAC ID 6608280466, 2 clinicians

Practice addresses (Care Compare)

3010 Palmer Way
Spring, TX 77380-4081
Phone 83293088901003

Hospital & facility affiliations

  • Aspire Hospital Hospital, Conroe, TX, CCN 670093
  • Houston Methodist the Woodlands Hospital Hospital, The Woodlands, TX, CCN 670122

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K3393TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast MRI & Diagnostics, Inc. CurrentSince Mar 1, 2024 Accepting new patients
Springwood Radiology Associates, PLLC Diagnostic Radiology CurrentSince Mar 15, 2021 Accepting new patients
River Oaks MRI & Diagnostic, LLC Diagnostic Radiology CurrentSince Sep 11, 2024 Accepting new patients

Locations

17191 St Lukes Way
Ste 110
The Woodlands, TX 77384
Phone (281) 720-8600

Interoperability endpoints

  • Direct secure messaging: dang.pham.1@19704.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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1104807528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 PALMER WAY",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773804081",
            "telephone_number": "832-930-8890",
            "fax_number": "713-929-3526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16750 RED OAK DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770902543",
            "telephone_number": "281-453-7110",
            "fax_number": "281-440-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "DANG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-11",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "K3393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116256205",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116256204",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.