NPIMap

Individual provider Active NPI

Huong-Duong Ngoc Phan, MD

  • Family Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1891257465
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
T7332 Issued in TX
Practice address
900 W Magnolia Ave Ste 201
Fort Worth, TX 76104-8518
Phone
(817) 912-9270
NPI assigned
Apr 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X T7332 TX Primary

Addresses

Primary practice location

900 W Magnolia Ave Ste 201
Fort Worth, TX 76104-8518

Mailing address

900 W Magnolia Ave Ste 201
Fort Worth, TX 76104-8518
Phone (817) 912-9270

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address UPMChospitals@upmcdirect.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221108002467 TX Practitioner - Family Practice 5193058519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Baylor College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

900 W Magnolia Ave
Suite 202
Fort Worth, TX 76104-8507
Phone (817) 333-6795

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T7332TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Family Medicine CurrentSince Oct 10, 2022 Accepting new patients
Healthtexas Provider Network Family Medicine Current Accepting new patients
Healthtexas Provider Network CurrentSince Oct 10, 2022 Accepting new patients
Healthtexas Provider Network Family Medicine Past Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

301 N Washington Ave
Fl 5
Dallas, TX 75246
Phone (469) 800-8742

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

900 W Magnolia Ave
Ste 202
Fort Worth, TX 76104
Phone (817) 333-6795

900 W Magnolia Ave
Ste 201
Ft Worth, TX 76104
Phone (817) 921-6166

Interoperability endpoints

  • Direct secure messaging: hphan1123074@direct.sw.org

Organizations & group practices 4

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 6

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

NPI Registry JSON

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1891257465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W MAGNOLIA AVE STE 201",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761048518",
            "telephone_number": "817-912-9270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W MAGNOLIA AVE STE 201",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761048518",
            "telephone_number": "817-912-9270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "HUONG-DUONG",
        "middle_name": "NGOC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-03",
        "last_updated": "2022-07-26",
        "certification_date": "2021-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T7332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UPMChospitals@upmcdirect.com",
            "affiliation": "N",
            "address_1": "600 Grant St Fl 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.