Kim Pham Co

Primary specialty

OptometristTaxonomy code 152W00000X

License

8070T Issued in TX

Legal business name

KIM PHAM CO

Doing business as

Select Vision Care

Practice address

1740 Highway 157 N
Mansfield, TX 76063-3921

Phone

(682) 518-8018

Fax

(682) 518-8017

NPI assigned

Sep 11, 2013

Last updated

Feb 21, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kim Pham, ODNPI 1124375548

Title

Owner

Phone

(817) 793-2959

Specialties & licenses 1

Addresses

Other names 1

• Select Vision Care Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kim Thi My Pham, O.D.

  • Optometrist
  • Mansfield, TX
  • NPI 1124375548
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1378857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708473600000",
    "number": "1598190381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2271",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760630047",
            "telephone_number": "817-793-2959",
            "fax_number": "682-518-8017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 HIGHWAY 157 N",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633921",
            "telephone_number": "682-518-8018",
            "fax_number": "682-518-8017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM PHAM CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-11",
        "last_updated": "2024-02-21",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-793-2959",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8070T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Select Vision Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Select Vision Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Megan Kerr
• Kerstin a Archer, MD, PA
• Khuong Phan, D.O., P.a. (Mansfield Medical Associates)
• Kidsville Pediatrics Mansfield
• Kidsville Pediatrics PLLC
• Mai Thanh Kim, PHARMD
• Young Kyu Kim, DMD
• Timothy Kimuyu, APRN
• Kindred Hospitals Limited Partnership (Kindred Hospital - Mansfield)
• Robin Patrice Kindred, M.D.

• Optometrist in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.