Active NPI
Donna Duyen Pham
- Pharmacist
- Haltom City, TX
National Provider Identifier
1669077665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 39639
- Practice address
- 3220 Denton Hwy
Haltom City, TX 76117-3717 - Phone
- (817) 831-4488
- NPI assigned
- Nov 30, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 39639 | TX | Primary |
Addresses
Primary practice location
3220 Denton Hwy
Haltom City, TX 76117-3717
Mailing address
4825 Eddleman Dr
Fort Worth, TX 76244-9122
Phone (817) 781-5937
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760586556 | Other | TX | 1760586556 |
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 |
|---|---|---|---|
| 39639 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606694400000",
"number": "1669077665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4825 EDDLEMAN DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "762449122",
"telephone_number": "817-781-5937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3220 DENTON HWY",
"city": "HALTOM CITY",
"state": "TX",
"postal_code": "761173717",
"telephone_number": "817-831-4488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "DONNA",
"middle_name": "DUYEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-30",
"last_updated": "2020-11-30",
"certification_date": "2020-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "39639",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "1760586556",
"identifier": "1760586556",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Haltom City, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.