Active NPI
Travis Thai Vinh Pham, PHARM.D.
- Pharmacist
- Houston, TX
National Provider Identifier
1144662115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 68590
- Practice address
- 1321 Upland Dr
#6660
Houston, TX 77043-4718 - Phone
- (559) 470-6969
- Fax
- (559) 470-6970
- NPI assigned
- Jul 19, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 68590 | CA | Primary |
| Pharmacist | 183500000X | 057528 | NY |
Addresses
Primary practice location
1321 Upland Dr
#6660
Houston, TX 77043-4718
Mailing address
1321 Upland Dr.
PO Box # 6660
Houston, TX 77043
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 057528 | NY | MD | Dentist |
| 68590 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454457600000",
"number": "1144662115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1321 UPLAND DR.",
"address_2": "PO BOX # 6660",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1321 UPLAND DR",
"address_2": "#6660",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770434718",
"telephone_number": "559-470-6969",
"fax_number": "559-470-6970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "TRAVIS",
"middle_name": "THAI VINH",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-07-19",
"last_updated": "2016-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "68590",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "057528",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.