Individual provider Active NPI

Khanh Truc Pham, PA-C

  • Physician Assistant
  • Cypress, TX
National Provider Identifier
1720508542
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
11122 Creekline Glen CT.
Cypress, TX 77429
Phone
(832) 533-4163
NPI assigned
Jun 22, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

11122 Creekline Glen CT.
Cypress, TX 77429

Mailing address

11122 Creekline Glen CT
Cypress, TX 77429-3675
Phone (832) 533-4163

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170920001592 CA Practitioner - Physician Assistant 5890069462 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Healthcare Network CurrentSince Aug 4, 2017 Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network CurrentSince Aug 4, 2017 Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Past Accepting new patients
Family Healthcare Network Past Accepting new patients

Locations

12586 Avenue 408
Orosi, CA 93647
Phone (559) 528-2804

305 E Center Ave
Visalia, CA 93291
Phone (559) 737-4792

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCECCA
  • Direct secure messaging: khanh.pham@fhcn.eclinicaldirectplus.com

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1720508542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11122 CREEKLINE GLEN CT",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774293675",
            "telephone_number": "832-533-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11122 CREEKLINE GLEN CT.",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "77429",
            "telephone_number": "832-533-4163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "KHANH",
        "middle_name": "TRUC",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, TX

Sources for this page

Verify at the official NPI Registry.