Physician Network Association

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

PAO1083 Issued in TX

Legal business name

PHYSICIAN NETWORK ASSOCIATION

Doing business as

n/a

Practice address

4036 Dumont Dr
Same As Above
Odessa, TX 79762-7132

Phone

(432) 368-2058

NPI assigned

Feb 1, 2008

Organization subpart

Yes

Parent organization

SAME ASAs reported in NPPES

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

Authorized official

Name

Mr. Trey Farthing, N/A

Title

President of P.N.a

Phone

(806) 799-1326

Specialties & licenses 1

Addresses

Other names 1

• n/a Doing business as

Tax ID family

Physician Network Association2 organizations share this tax ID, including this one

Part of

Physician Network Association

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Physicians Network Association

  • Health Maintenance Organization
  • Houston, TX
  • NPI 1568613438
  NPD tax ID

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

{
    "created_epoch": "1201824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1770761769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4036 DUMONT DR",
            "address_2": "SAME AS ABOVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797627132",
            "telephone_number": "432-368-2058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4036 DUMONT DR",
            "address_2": "SAME AS ABOVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797627132",
            "telephone_number": "432-368-2058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN NETWORK ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAME AS",
        "enumeration_date": "2008-02-01",
        "last_updated": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "FARTHING",
        "authorized_official_first_name": "TREY",
        "authorized_official_title_or_position": "PRESIDENT OF P.N.A",
        "authorized_official_telephone_number": "18067991326",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "N/A"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "TX",
            "license": "PAO1083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "n/a",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thanh Thao Thi Pham
• Travis Cong Pham, MD
• Henry Phe, PHARMD
• Indavong Phonasa, FNP-C
• Physician Management Services of Western Texas, LLC
• Phytex Rehabilitation, LLC (PhyTEx Rehabilitation & Sports Medicine Associates)
• Phytex Rehabilitation, LLC (PhyTEx West University)
• Deborah L Pickens, M.D.
• Katherine Elizabeth Pierce, MS.CCC/SLP
• Kimberly Pierce

• Point of Service in Odessa, TX
• Providers in Odessa, TX by specialty
• Point of Service in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.