Bao Quang Pham, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

R5625 Issued in TX

Practice address

12221 N Mopac Expy
Austin, TX 78758

Phone

(314) 724-2766

NPI assigned

May 16, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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 Osteopathy

State licenses

Practice roles

Locations

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.

• Emergency Associates of Central Texas PA

  • Emergency Medicine Physician
  • Killeen, TX
  • NPI 1215418280
  Medicare reassignment NPD
• Emergency Services of Texas PA

  • Emergency Medicine Physician
  • Orange, TX
  • NPI 1174932131
  Medicare reassignment NPD
• Longhorn Emergency Medical Associates PA

  • Emergency Medicine Physician
  • Austin, TX
  • NPI 1649669672
  Medicare reassignment NPD

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

{
    "created_epoch": "1400198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574294400000",
    "number": "1356752984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11509 ERIC HEIDEN CT",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787482019",
            "telephone_number": "314-724-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12221 N MOPAC EXPY",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78758",
            "telephone_number": "314-724-2766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29000 Center Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Westlake",
            "state": "OH",
            "postal_code": "441455293",
            "country_code": "US",
            "telephone_number": "314-724-2766",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4141 S Staples St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Corpus Christi",
            "state": "TX",
            "postal_code": "78411",
            "country_code": "US",
            "telephone_number": "314-724-2766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "BAO",
        "middle_name": "QUANG",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-16",
        "last_updated": "2019-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34.012393",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "R5625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Tat-Huy Pham, MD
• An Minh Pham
• Andrew Baolong Pham, M.D
• Angelica Pham, M.ED., BCBA, LBA
• Austin Pham
• Binh V Pham, M.D.
• Catherine M Pham, M.D.
• Diem Huong Pham, MD
• Grace S Pham
• Kevin Pham, DDS

• Emergency Medicine Physician in Austin, TX
• Providers in Austin, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.