Organization Active NPI

Luan Q. Pho, M.D., P.a.

  • Internal Medicine Physician
  • Allen, TX
National Provider Identifier
1235205170
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
K0361 Issued in TX
Legal business name
LUAN Q. PHO, M.D., P.A.
Practice address
1105 Central Expy N
Suite 260
Allen, TX 75013-6104
Phone
(972) 747-4700
NPI assigned
Nov 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Authorized official

Name
Dr. Luan Quoc Pho, M.D.NPI 1821080995
Title
President
Phone
(972) 747-4700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X K0361 TX Primary

Addresses

Primary practice location

1105 Central Expy N
Suite 260
Allen, TX 75013-6104

Mailing address

1105 Central Expy N
Suite 260
Allen, TX 75013-6104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141219000475 TX Part B Supplier - Clinic/Group Practice 4880917095 Receives reassigned benefits from 1 practitioner
Practice locations: Allen, TX

National Provider Directory

National Provider Directory

Locations

1105 Central Expy N
Ste 260
Allen, TX 75013
Phone (972) 747-4700

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184544000000",
    "number": "1235205170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 CENTRAL EXPY N",
            "address_2": "SUITE 260",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750136104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 CENTRAL EXPY N",
            "address_2": "SUITE 260",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750136104",
            "telephone_number": "972-747-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUAN Q. PHO, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2007-07-16",
        "status": "A",
        "authorized_official_last_name": "PHO",
        "authorized_official_first_name": "LUAN",
        "authorized_official_middle_name": "QUOC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-747-4700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K0361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.