Trung Pham, OD
Individual provider Active NPI Optometrist · Irving, TX
NPI 1821722646 · NPPES record last updated Jul 16, 2022
Key facts
- NPI
- 1821722646
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 10546T (TX)
- Practice address
- 7750 N Macarthur Blvd Ste 180
Irving, TX 75063-7524 - Phone
- (972) 401-0008
- NPI assigned
- Jul 16, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230504002254 | TX | Practitioner - Optometry | 5092170514 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eyecare 20/20, P.C. | Optometrist | Current |
Accepting new patients |
| 20-20 Sight, PA | Optometrist | Current |
Accepting new patients |
| 2020 Icare and Iwear Irving PLLC | Optometrist | Current |
Accepting new patients |
Locations
4116 S Carrier Pkwy
Ste 120
Grand Prairie, TX 75052
Phone (972) 264-7200
7750 N MacArthur Blvd
Ste 180
Irving, TX 75063
Phone (972) 401-0008
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 10546T | TX | Yes |
Addresses
Primary practice location
7750 N Macarthur Blvd Ste 180
Irving, TX 75063-7524
Mailing address
5535 Brazoria Dr
Grand Prairie, TX 75052-8575
Phone (817) 703-4905
Other practice location 1
4116 S Carrier Pkwy Ste 120
Grand Prairie, TX 75052-3245
Phone (972) 264-7200
Other providers in Irving, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.