Audrey Marietta Phan, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

W7753 Issued in TX

Practice address

3201 E President George Bush Hwy Ste 107
Richardson, TX 75082-3565

Phone

(972) 276-9902

NPI assigned

Apr 7, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

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

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1922740356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 S GOOD LATIMER EXPY APT 2386",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752261848",
            "telephone_number": "847-840-8790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 E PRESIDENT GEORGE BUSH HWY STE 107",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750823565",
            "telephone_number": "972-276-9902"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1441 N Beckley Ave",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752031201",
            "country_code": "US",
            "telephone_number": "214-947-6700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAN",
        "first_name": "AUDREY",
        "middle_name": "MARIETTA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-07",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "W7753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lesley Anne Pettit
• Kim Pham, PHARMD
• Lauren Hanh Pham
• Phat Pham
• Quan D Pham, D.C.
• Bao Long Phan, M.D.
• Danielle Phan, D.D.S
• Lanh Phan, PHARMD
• Nghi Bao Phan, MD
• Quynh-Dao Nguyen Phan, PHARM D

• Obstetrics & Gynecology Physician in Richardson, TX
• Providers in Richardson, TX by specialty
• Obstetrics & Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; 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.