Individual provider Active NPI

Tony Ai Pham, M.D.

  • Psychiatry Physician
  • Houston, TX
National Provider Identifier
1245419225
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
M5883 Issued in TX
Practice address
1315 St Joseph Pkwy 1307
Houston, TX 77002-8236
Phone
(713) 376-3459
Fax
(832) 369-7665
NPI assigned
Oct 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Psychiatry Physician 2084P0802X M5883 TX
Psychiatry Physician 2084P0800X M5883 TX Primary

Addresses

Primary practice location

1315 St Joseph Pkwy 1307
Houston, TX 77002-8236

Mailing address

2247 Goldsmith St
Houston, TX 77030-1118
Phone (713) 376-3459

Other identifiers 2

IdentifierTypeStateIssuer
173990604MedicaidTX
173990601MedicaidTX

Other names 1

  • Dr. Ai CHI Pham Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050624000870 TX Practitioner - Psychiatry 6507801024 Practice locations: Houston, TX

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Baylor College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1315 St Joseph Pkwy
Houston, TX 77002-8236
Phone (713) 376-3459

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M5883TXMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tony a Pham MD PA Psychiatry CurrentSince Jan 1, 1990 Accepting new patients
Primary Medicine Center LLC Psychiatry Past Accepting new patients

Locations

1315 St Joseph Pkwy
Ste 1307
Houston, TX 77002
Phone (713) 376-3459

Interoperability endpoints

  • Direct secure messaging: tonya.pham@tonyaphammdpa.chartmakerdirect.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1245419225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2247 GOLDSMITH ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301118",
            "telephone_number": "713-376-3459",
            "fax_number": "832-369-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 ST JOSEPH PKWY 1307",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770028236",
            "telephone_number": "713-376-3459",
            "fax_number": "832-369-7665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "TONY",
        "middle_name": "AI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-26",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "TX",
            "license": "M5883",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "M5883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173990604",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173990601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AI",
            "last_name": "PHAM",
            "middle_name": "CHI",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.