Linda K Phan, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

M4914 Issued in TX

Practice address

252 Matlock Rd Ste 300
Mansfield, TX 76063-4294

Phone

(817) 557-5473

Fax

(817) 539-0476

NPI assigned

Aug 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: lphan613424@direct.childrens.com

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.

• Dallas Physician Medical Services for Children Inc

  • Pediatrics Physician
  • Dallas, TX
  • NPI 1194153650
  Medicare reassignment NPD
• Medical Clinic of North Texas, PLLC

  • Internal Medicine Physician
  • Arlington, TX
  • NPI 1033167234

  Pediatrics

  Medicare reassignment NPD
• Dallas Physician Medical Services for Children Inc

  • Pediatrics Physician
  • Dallas, TX
  • NPI 1558407908
  NPD
• Medical Clinic of North Texas PLLC

  • Radiation Oncology Clinic/Center
  • Arlington, TX
  • NPI 1184131625
  NPD

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1235245895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 MATLOCK RD STE 300",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760634294",
            "telephone_number": "817-557-5473",
            "fax_number": "817-539-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 MATLOCK RD STE 300",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760634294",
            "telephone_number": "817-557-5473",
            "fax_number": "817-539-0476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "LINDA",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "TEMPLP",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M4914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184093605",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP NPI NUMBER",
            "identifier": "1669442042",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathlynn Pham, PHARM.D
• Kim Thi My Pham, O.D.
• Mai Pham, DPM
• Phuong Pham, OD
• Johnny Phan, O.D.
• Phi Thuong Phan, PHARM D
• Uyen Ngoc Bao Phan, PA
• Pharmatise
• Jacqueline Phelps
• Minu Bijo Philip, PMHNP-BC

• Pediatrics Physician in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.