Individual provider Active NPI

Connie L Pham, M.D.

  • Internal Medicine Physician
  • Houston, TX
National Provider Identifier
1730165648
Registry record updated Dec 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
H8321 Issued in TX
Practice address
7850 Parkwood Circle Drive Suite A7
Houston, TX 77036
Phone
(512) 704-2282
NPI assigned
Dec 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X H8321 TX Primary

Addresses

Primary practice location

7850 Parkwood Circle Drive Suite A7
Houston, TX 77036

Mailing address

7850 Parkwood Circle Drive Suite A7
Houston, TX 77036
Phone (512) 704-2282

Other identifiers 2

IdentifierTypeStateIssuer
033970702MedicaidTX
P00825942OtherTXRRMCR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100219000652 TX Practitioner - Internal Medicine 7012051691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Medical Branch at Galveston, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group Gulf Coast PLLCGroup PAC ID 4688999022, 511 clinicians

Practice addresses (Care Compare)

7850 Parkwood Circle Dr
Suite a 7
Houston, TX 77036-6760
Phone (346) 220-6388

7900 Fannin St
Suite 4000
Houston, TX 77054-2935
Phone (713) 512-7500

Hospital & facility affiliations

  • Memorial Hermann Hospital System Hospital, Houston, TX, CCN 450184
  • Memorial Hermann Memorial City Hospital Hospital, Houston, TX, CCN 450610

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Gulf Coast, PLLC CurrentSince Feb 4, 2021 Accepting new patients
Privia Medical Group Gulf Coast PLLC CurrentSince Feb 4, 2021 Accepting new patients
Austin Gastroenterology PA Past Accepting new patients

Locations

646 FM 517 Rd W
Dickinson, TX 77539
Phone (281) 309-9001

7900 Fannin St
Ste 4000
Houston, TX 77054
Phone (713) 512-7027

7850 Parkwood Circle Dr
Ste A-7
Houston, TX 77036
Phone (281) 689-2605

10970 Shadow Creek Pkwy
Ste 100
Pearland, TX 77584
Phone (281) 398-8500

17510 W Grand Pkwy S
Ste 430
Sugar Land, TX 77479
Phone (713) 578-3820

Interoperability endpoints

  • Direct secure messaging: connie.pham.1@8042.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607731200000",
    "number": "1730165648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7850 PARKWOOD CIRCLE DRIVE SUITE A7",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77036",
            "telephone_number": "512-704-2282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7850 PARKWOOD CIRCLE DRIVE SUITE A7",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77036",
            "telephone_number": "512-704-2282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "CONNIE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2020-12-12",
        "certification_date": "2020-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "H8321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "033970702",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMCR",
            "identifier": "P00825942",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.