Individual provider Active NPI

Nikki Minh Pham, PT

  • Physical Therapist
  • Lewisville, TX
National Provider Identifier
1972804011
Registry record updated Nov 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1197749 Issued in TX
Practice address
966 N Garden Ridge Blvd
Suite 530
Lewisville, TX 75077-2827
Phone
(972) 420-6605
Fax
(972) 436-2770
NPI assigned
Nov 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1197749 TX Primary

Addresses

Primary practice location

966 N Garden Ridge Blvd
Suite 530
Lewisville, TX 75077-2827

Mailing address

966 N Garden Ridge Blvd
Suite 530
Lewisville, TX 75077-2827
Phone (972) 420-6605

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

NPI Registry JSON

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

{
    "created_epoch": "1288915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288915200000",
    "number": "1972804011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "966 N GARDEN RIDGE BLVD",
            "address_2": "SUITE 530",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750772827",
            "telephone_number": "972-420-6605",
            "fax_number": "972-436-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "966 N GARDEN RIDGE BLVD",
            "address_2": "SUITE 530",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750772827",
            "telephone_number": "972-420-6605",
            "fax_number": "972-436-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "NIKKI",
        "middle_name": "MINH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-05",
        "last_updated": "2010-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1197749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2010; 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.