Active NPI
Quan Pham
- Pharmacist
- Round Rock, TX
National Provider Identifier
1689289837
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 64544
- Practice address
- 800 W Old Settlers Blvd
Round Rock, TX 78681-2119 - Phone
- (512) 255-1331
- NPI assigned
- Sep 14, 2020
- Last updated
- Sep 14, 2020
- Sex
- Male
- 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 | 64544 | TX | Primary |
Addresses
Primary practice location
800 W Old Settlers Blvd
Round Rock, TX 78681-2119
Mailing address
1203 Summerdale LN
Wylie, TX 75098-8419
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64544 | Other | TX | N/A |
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 |
|---|---|---|---|
| 64544 | TX | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Pharmacy Inc | Past | Accepting new patients | |
| CVS Pharmacy Inc | 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": "1600041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600041600000",
"number": "1689289837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1203 SUMMERDALE LN",
"city": "WYLIE",
"state": "TX",
"postal_code": "750988419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 W OLD SETTLERS BLVD",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786812119",
"telephone_number": "512-255-1331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "QUAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-09-14",
"last_updated": "2020-09-14",
"certification_date": "2020-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "64544",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "N/A",
"identifier": "64544",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Round Rock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.