Tess Pham Bruette, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

T3592 Issued in TX

Practice address

890 E Travis St
La Grange, TX 78945-2364

Phone

(844) 835-2748

Fax

(979) 968-2001

NPI assigned

Mar 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Tess Ly Pham Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: tess.bruette.p1@direct.tejashealthcare.nextgenshare.com

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.

• Tejas Health Care

  • Federally Qualified Health Center (FQHC)
  • La Grange, TX
  • NPI 1073779500

  TX

  Medicare reassignment NPD
• Tejas Health Care

  • Federally Qualified Health Center (FQHC)
  • Giddings, TX
  • NPI 1215326491
  NPD

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657929600000",
    "number": "1811458797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "753 E TRAVIS ST",
            "city": "LA GRANGE",
            "state": "TX",
            "postal_code": "789452353",
            "telephone_number": "979-968-6596",
            "fax_number": "979-968-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 E TRAVIS ST",
            "city": "LA GRANGE",
            "state": "TX",
            "postal_code": "789452364",
            "telephone_number": "844-835-2748",
            "fax_number": "979-968-2001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 S 31st St",
            "address_purpose": "LOCATION",
            "city": "Temple",
            "state": "TX",
            "postal_code": "765080001",
            "country_code": "US",
            "telephone_number": "254-935-5063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUETTE",
        "first_name": "TESS",
        "middle_name": "PHAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2022-07-16",
        "certification_date": "2022-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "T3592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TESS",
            "last_name": "PHAM",
            "middle_name": "LY",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in La Grange, TX
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.