Individual provider Active NPI

Trong Quang Pham, MD

  • General Practice Physician
  • Dallas, TX
National Provider Identifier
1629369020
Registry record updated Apr 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
23097 Issued in CO
Practice address
207 S Houston St Ste 400
Dallas, TX 75202-4799
Phone
(214) 655-3210
Fax
(214) 655-3212
NPI assigned
Apr 20, 2011
Last updated
Apr 20, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 23097 CO Primary

Addresses

Primary practice location

207 S Houston St Ste 400
Dallas, TX 75202-4799

Mailing address

207 S Houston St Ste 400
Dallas, TX 75202-4799
Phone (214) 655-3210

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23097COMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303257600000",
    "number": "1629369020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 S HOUSTON ST STE 400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752024799",
            "telephone_number": "214-655-3210",
            "fax_number": "214-655-3212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 S HOUSTON ST STE 400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752024799",
            "telephone_number": "214-655-3210",
            "fax_number": "214-655-3212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "TRONG",
        "middle_name": "QUANG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-20",
        "last_updated": "2011-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CO",
            "license": "23097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.