Phoenix Physicians Ipa, LLC

Primary specialty

Prevention ProfessionalTaxonomy code 405300000X

Legal business name

PHOENIX PHYSICIANS IPA, LLC

Practice address

6030 S Rice Ave Ste C
Houston, TX 77081-2944

Phone

(818) 399-8996

NPI assigned

Oct 21, 2024

Organization subpart

No

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

Authorized official

Name

Ms. Lan Nhu Bich Phan

Title

Administrator

Phone

(818) 399-8996

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1729468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1669293841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 VERANDA",
            "city": "NEWPORT COAST",
            "state": "CA",
            "postal_code": "926571632",
            "telephone_number": "818-399-8996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6030 S RICE AVE STE C",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770812944",
            "telephone_number": "818-399-8996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX PHYSICIANS IPA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-21",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "LAN",
        "authorized_official_middle_name": "NHU BICH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "818-399-8996",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "405300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Prevention Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prevention Professional in Houston, TX
• Providers in Houston, TX by specialty
• Prevention Professional in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.