Individual provider Active NPI

Tam Pham

  • Pharmacist
  • Oklahoma City, OK
National Provider Identifier
1124985569
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
21158 Issued in OK
Practice address
13503 S Santa Fe Ave
Oklahoma City, OK 73170-7314
Phone
(405) 300-6418
Fax
(405) 300-6417
NPI assigned
Jan 7, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 21158 OK Primary

Addresses

Primary practice location

13503 S Santa Fe Ave
Oklahoma City, OK 73170-7314

Mailing address

13503 S Santa Fe Ave
Oklahoma City, OK 73170-7314
Phone (405) 300-6418

Other names 1

  • Nathan Pham Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
21158OKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores East LP PastSince Nov 3, 2024 Accepting new patients
Wal-Mart Stores East, LP Past Accepting new patients

Organizations & group practices 2

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": "1767744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1124985569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13503 S SANTA FE AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731707314",
            "telephone_number": "405-300-6418",
            "fax_number": "405-300-6417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13503 S SANTA FE AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731707314",
            "telephone_number": "405-300-6418",
            "fax_number": "405-300-6417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "TAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-01-07",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "21158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NATHAN",
            "last_name": "PHAM",
            "credential": "PHARMD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.