Active NPI
Tracy Tram Pham
- Pharmacist
- Ennis, TX
National Provider Identifier
1922608793
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 56329
- Practice address
- 700 E Ennis Ave
Ennis, TX 75119-4209 - Phone
- (972) 875-9636
- NPI assigned
- Oct 29, 2020
- Last updated
- Oct 29, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 56329 | TX | Primary |
Addresses
Primary practice location
700 E Ennis Ave
Ennis, TX 75119-4209
Mailing address
5538 Dorchester LN
Garland, TX 75040-4493
Phone (214) 718-4156
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56329 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603929600000",
"number": "1922608793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5538 DORCHESTER LN",
"city": "GARLAND",
"state": "TX",
"postal_code": "750404493",
"telephone_number": "214-718-4156"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 E ENNIS AVE",
"city": "ENNIS",
"state": "TX",
"postal_code": "751194209",
"telephone_number": "972-875-9636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "TRACY",
"middle_name": "TRAM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-29",
"last_updated": "2020-10-29",
"certification_date": "2020-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "56329",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ennis, TX
- Peak Physical Therapy and Rehabilitation LLC (Peak Physical Therapy & Sports Medicine Center of Ennis)
- Pecan Grove Healthcare
- Davey M Perrin, MD
- Kristen Elizabeth Persilver
- Ruthie A Pfueller, PTA
- Kristen S Pike, LPC
- Podiatric Medical Partners of Texas, PA (Family Foot & Ankle Centers)
- Mark Christopher Pollard
- Preferred Care Health Facilities of Texas I Inc (Ennis Care Center)
- Premier Care Services of Ennis, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.