Loan Pham
Individual provider Active NPI Occupational Therapy Assistant · Fulton, TX
NPI 1134719909 · NPPES record last updated Jan 25, 2021
Key facts
- NPI
- 1134719909
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 214478 (TX)
- Practice address
- 316 N 11TH St
Fulton, TX 78358 - Phone
- (713) 303-5678
- NPI assigned
- Jan 25, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 214478 | TX | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 214478 | TX | Yes |
Addresses
Primary practice location
316 N 11TH St
Fulton, TX 78358
Mailing address
PO Box 1554
Fulton, TX 78358-1554
Phone (713) 303-5678
Other providers in Fulton, TX
- Carolyn R Hall
- Michael Heffernan
- Patricia Hoefar
- Nhi Nguyen
- Jay Pearce
- Nekisha Lynn Shahan
- South Texas Sports Medicine Inc
- Kristan Michele Steckler
All providers in Fulton, TX · Occupational Therapy Assistant in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.