Individual provider Active NPI

Hai Van Pham, MD

  • Internal Medicine Physician
  • San Antonio, TX
National Provider Identifier
1316042849
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
J9781 Issued in TX
Practice address
4800 Fredericksburg Rd
Ste 127
San Antonio, TX 78229-3628
Phone
(210) 733-5072
Fax
(210) 733-8649
NPI assigned
Sep 13, 2006
Last updated
Sep 4, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X J9781 TX
Geriatric Medicine (Family Medicine) Physician 207QG0300X J9781 TX
Internal Medicine Physician 207R00000X J9781 TX Primary

Addresses

Primary practice location

4800 Fredericksburg Rd
Ste 127
San Antonio, TX 78229-3628

Mailing address

PO Box 1239
Troy, MI 48099-1239
Phone (248) 824-6600

Other identifiers 3

IdentifierTypeStateIssuer
0002MUOtherTXGROUP BCBS OF TX
P00296211OtherTXRAIL ROAD MEDICARE
179041201MedicaidTX

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
I20060209000713 TX Practitioner - Internal Medicine 2466467527 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J9781TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa of Texas PLLC CurrentSince Jan 30, 2006 Accepting new patients
Vpa of Texas PLLC Family Medicine Current Accepting new patients
Vpa of Texas PLLC Family Medicine CurrentSince Jan 30, 2006 Accepting new patients

Locations

7800 Shoal Creek Blvd
Ste 118W
Austin, TX 78757
Phone (512) 374-0700

1301 W 7th St
Ste 121
Ft Worth, TX 76102
Phone (817) 348-0425

8588 Katy Fwy
Ste 226A
Houston, TX 77024
Phone (713) 532-6884

4538 Centerview
Ste 149
San Antonio, TX 78228
Phone (210) 579-4892

4800 Fredericksburg Rd
Ste 127
San Antonio, TX 78229
Phone (210) 348-5681

5414 Fredericksburg Rd
Ste 100A
San Antonio, TX 78229
Phone (210) 468-0800

Organizations & group practices 3

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1316042849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1239",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480991239",
            "telephone_number": "248-824-6600",
            "fax_number": "248-324-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 FREDERICKSBURG RD",
            "address_2": "STE 127",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293628",
            "telephone_number": "210-733-5072",
            "fax_number": "210-733-8649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "HAI",
        "middle_name": "VAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J9781",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "J9781",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "J9781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP BCBS OF TX",
            "identifier": "0002MU",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00296211",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179041201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.