Individual provider Active NPI

Tram Pham, PA-C

  • Medical Physician Assistant
  • San Antonio, TX
National Provider Identifier
1811367451
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
593868 Issued in TX
Practice address
3619 Paesanos Pkwy Ste 212
San Antonio, TX 78231-1255
Phone
(210) 233-7000
Fax
(210) 690-5595
NPI assigned
Sep 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 593868 TX Primary

Addresses

Primary practice location

3619 Paesanos Pkwy Ste 212
San Antonio, TX 78231-1255

Mailing address

3066 E Commerce St
San Antonio, TX 78220-1013
Phone (210) 233-7647

Other practice location 1

607 Camden St
San Antonio, TX 78215-1610
Phone (210) 918-8854

Other practice location 2

607 Camden St
San Antonio, TX 78215-1610
Phone (210) 918-8854

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161012002030 TX Practitioner - Physician Assistant 8123316809 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
593868TXMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: tram.pham@commsa.eclinicaldirectplus.com

Organizations & group practices 1

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": "1443139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1811367451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3066 E COMMERCE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782201013",
            "telephone_number": "210-233-7647",
            "fax_number": "210-228-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3619 PAESANOS PKWY STE 212",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782311255",
            "telephone_number": "210-233-7000",
            "fax_number": "210-690-5595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "607 Camden St",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782151610",
            "country_code": "US",
            "telephone_number": "210-918-8854",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "607 Camden St",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782151610",
            "country_code": "US",
            "telephone_number": "210-918-8854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "TRAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-25",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "593868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.