Thao Nguyen Thi Phan, PHARM D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

13346 Issued in OK

Practice address

15100 N Western Ave
Edmond, OK 73013-1108

Phone

(405) 330-3742

Fax

(405) 330-5747

NPI assigned

Sep 13, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Tina Phan Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Walgreen Co

  • Pharmacy
  • Edmond, OK
  • NPI 1124035035
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315872000000",
    "number": "1417239773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 NW 175TH ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730126901",
            "telephone_number": "405-513-2037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15100 N WESTERN AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730131108",
            "telephone_number": "405-330-3742",
            "fax_number": "405-330-5747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "THAO NGUYEN",
        "middle_name": "THI",
        "name_prefix": "Dr.",
        "credential": "PHARM D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "13346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "PHAN",
            "prefix": "DR.",
            "credential": "PHARM D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Brianna N Petty, COTA/L
• Karlee Jo Pfaff, PA-C
• Kallee Mae Pfeiffer, PHARMD, RPH
• Brian Pfenninger, MBA, RDCS, RDMS
• Haley Pfundt, CCC-SLP
• Rebecca Jane Phansalkar
• Pharmacy Providers of Oklahoma Inc
• Brian Steven Phelps, MD
• Philip M Gray, DDS, PLLC
• Philip R Budd, PSYD PLLC

• Pharmacist in Edmond, OK
• Providers in Edmond, OK by specialty
• Pharmacist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.