Long Henry Pham, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

J0861 Issued in TX

Practice address

2206 E Villa Maria Rd
Bryan, TX 77802-2547

Phone

(979) 776-4600

Fax

(979) 774-0877

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Gastroenterology

Education

University of Texas Medical School at Houston, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Texas Digestive Disease Association, PAGroup PAC ID 4284618711, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI St Joseph Health Regional Hospital Hospital, Bryan, TX, CCN 450011

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: centraltexasgi@directaddress.net

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.

• Central Texas Digestive Disease Association, PA

  dba Central Texas Gastroenterology Consultants

  • Gastroenterology Physician
  • Bryan, TX
  • NPI 1639260763
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Joseph Regional Health Center

  • General Acute Care Hospital
  • Bryan, TX
  • NPI 1942294939
  Care Compare affiliation
• St. Joseph Regional Health Center

  dba CHI St. Joseph Health College Station Hospital

  • General Acute Care Hospital
  • College Station, TX
  • NPI 1053963009
  Care Compare affiliation

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1366553380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2206 E VILLA MARIA RD",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022547",
            "telephone_number": "979-776-4600",
            "fax_number": "979-774-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2206 E VILLA MARIA RD",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022547",
            "telephone_number": "979-776-4600",
            "fax_number": "979-774-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "LONG",
        "middle_name": "HENRY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "J0861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047977601",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "centraltexasgi@directaddress.net",
            "affiliation": "N",
            "address_1": "2206 E Villa Maria Rd",
            "city": "Bryan",
            "state": "TX",
            "country_code": "US",
            "postal_code": "778022547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Naketa Perry
• Christy Renee Peterek, OTR
• Cody Peterman
• Ariel Petranek
• Jonathan Pham, PHARMD
• Jarrod Pharr, DDS
• Tyler David Pharr, DDS
• Phil&Neet Enterprises LLC (Fyzical Therapy & Balance Centers)
• Allanna Phillips
• Gerald D Phillips, O.D.

• Gastroenterology Physician in Bryan, TX
• Providers in Bryan, TX by specialty
• Gastroenterology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.