Individual provider Active NPI

Tammy Pham, PA-C

  • Physician Assistant
  • Schertz, TX
National Provider Identifier
1205704715
Registry record updated Nov 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA19700 Issued in TX
Practice address
3701 Roy Richard Dr
Schertz, TX 78154-2796
Phone
(210) 945-2121
NPI assigned
Oct 27, 2025
Last updated
Nov 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA19700 TX Primary

Addresses

Primary practice location

3701 Roy Richard Dr
Schertz, TX 78154-2796

Mailing address

3701 Roy Richard Dr
Schertz, TX 78154-2796

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260310002307 TX Practitioner - Physician Assistant 3779066626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kellum Physician Partners PAGroup PAC ID 1850553058, 17 clinicians

Practice addresses (Care Compare)

3701 FM
3009 Suite 101
Schertz, TX 78154-2796
Phone (210) 945-2121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA19700TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kellum Physician Partners, PA CurrentSince Jan 1, 2026 Accepting new patients

Locations

1 FM 3351 S
Ste 135
Boerne, TX 78006
Phone (210) 675-6724

3903 Wiseman Blvd
Ste 215
San Antonio, TX 78251
Phone (210) 675-6724

3701 FM 3009
Ste 101
Schertz, TX 78154
Phone (210) 945-2121

3701 Roy Richard Dr
Schertz, TX 78154
Phone (210) 359-0051

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1761523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764288000000",
    "number": "1205704715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 ROY RICHARD DR",
            "city": "SCHERTZ",
            "state": "TX",
            "postal_code": "781542796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 ROY RICHARD DR",
            "city": "SCHERTZ",
            "state": "TX",
            "postal_code": "781542796",
            "telephone_number": "210-945-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "TAMMY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-27",
        "last_updated": "2025-11-28",
        "certification_date": "2025-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA19700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schertz, TX

Sources for this page

Verify at the official NPI Registry.