Active NPI
Tai Tien Phan
- Pharmacist
- McAllen, TX
National Provider Identifier
1578175832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 63011
- Practice address
- 701 E Ridge Rd
McAllen, TX 78503-1553 - Phone
- (956) 683-9392
- NPI assigned
- Aug 18, 2020
- Last updated
- Dec 20, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 63011 | TX | Primary |
Addresses
Primary practice location
701 E Ridge Rd
McAllen, TX 78503-1553
Mailing address
1406 E Harrison Ave
Harlingen, TX 78550-7101
Phone (956) 412-8362
Other practice location 1
1406 E Harrison Ave
Harlingen, TX 78550-7101
Phone (956) 412-8362
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63011 | TX | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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": "1597708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671494400000",
"number": "1578175832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1406 E HARRISON AVE",
"city": "HARLINGEN",
"state": "TX",
"postal_code": "785507101",
"telephone_number": "956-412-8362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 E RIDGE RD",
"city": "MCALLEN",
"state": "TX",
"postal_code": "785031553",
"telephone_number": "956-683-9392"
}
],
"practiceLocations": [
{
"address_1": "1406 E Harrison Ave",
"address_purpose": "LOCATION",
"city": "Harlingen",
"state": "TX",
"postal_code": "785507101",
"country_code": "US",
"telephone_number": "956-412-8362",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PHAN",
"first_name": "TAI",
"middle_name": "TIEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-18",
"last_updated": "2022-12-20",
"certification_date": "2022-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "63011",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McAllen, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.