Individual provider Active NPI

Phillip C. Phan, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Houston, TX
National Provider Identifier
1942399548
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
N2242 Issued in TX
Practice address
5445 La Branch St Ste 100
Houston, TX 77004-6835
Phone
(713) 973-7246
NPI assigned
Oct 12, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X N2242 TX
Interventional Pain Medicine Physician 208VP0014X N2242 TX
Pain Medicine (Anesthesiology) Physician 207LP2900X N2242 TX Primary

Addresses

Primary practice location

5445 La Branch St Ste 100
Houston, TX 77004-6835

Mailing address

5445 La Branch St Ste 100
Houston, TX 77004-6835
Phone (713) 973-7246

Other practice location 1

7700 Main St
Suite 400
Houston, TX 77030-4456
Phone (832) 553-1336

Other identifiers 1

IdentifierTypeStateIssuer
179470307MedicaidTX

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1942399548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5445 LA BRANCH ST STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770046835",
            "telephone_number": "713-973-7246",
            "fax_number": "832-553-1337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5445 LA BRANCH ST STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770046835",
            "telephone_number": "713-973-7246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7700 Main St",
            "address_2": "Suite 400",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770304456",
            "country_code": "US",
            "telephone_number": "832-553-1336",
            "fax_number": "832-553-1337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAN",
        "first_name": "PHILLIP",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "TX",
            "license": "N2242",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "TX",
            "license": "N2242",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TX",
            "license": "N2242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179470307",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.