NPIMap

Individual provider Active NPI

Bao Thang Pham, MD

  • Family Medicine Physician
  • Houston, TX
National Provider Identifier
1417098500
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M1292 Issued in TX
Practice address
12545 Briar Forest Dr Ste a
Houston, TX 77077-2900
Phone
(281) 531-5293
Fax
(281) 759-9175
NPI assigned
Feb 9, 2007
Last updated
Sep 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M1292 TX Primary

Addresses

Primary practice location

12545 Briar Forest Dr Ste a
Houston, TX 77077-2900

Mailing address

12545 Briar Forest Dr Ste a
Houston, TX 77077-2900
Phone (281) 531-5293

Other names 1

  • Dr. Tommy Pham Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080529000186 TX Practitioner - Family Practice 5890865182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in Shreveport, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

12545 Briar Forest Dr
Suite a
Houston, TX 77077-2900
Phone (281) 531-5293

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M1292TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avc Health Ipa, LLC Current Accepting new patients
Pham Medical Clinic PA Family Medicine CurrentSince Oct 1, 2008 Accepting new patients
Dairy Ashford Family Practice Associates, P.a. Past Accepting new patients
Wang&Jiang, MD, PA Family Medicine PastSince Apr 28, 2004 Accepting new patients

Locations

12545 Briar Forest Dr
Ste A
Houston, TX 77077
Phone (281) 531-5293

Interoperability endpoints

  • Direct secure messaging: tommypham@phammedicalclinic.amazing-direct.com

Organizations & group practices 4

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.

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1417098500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12545 BRIAR FOREST DR STE A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770772900",
            "telephone_number": "281-531-5293",
            "fax_number": "281-759-9175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12545 BRIAR FOREST DR STE A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770772900",
            "telephone_number": "281-531-5293",
            "fax_number": "281-759-9175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "BAO",
        "middle_name": "THANG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M1292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TOMMY",
            "last_name": "PHAM",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.