Thanh-Diu Thi Pham, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2162 Issued in KY

Practice address

2206 N John Redditt Dr
Lufkin, TX 75904-1776

Phone

(936) 671-4300

Fax

(936) 671-4323

NPI assigned

Dec 31, 2013

Last updated

Mar 3, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Angelina Diagnostic Radiology Associates

  dba ADRA Medical Imaging

  • Diagnostic Radiology Physician
  • Lufkin, TX
  • NPI 1033175302
  Medicare reassignment NPD
• Comprehensive Rehab Consultants PLLC

  dba Comprehensive Rehab Consultants LLC

  • Physical Medicine & Rehabilitation Physician
  • Middle River, MD
  • NPI 1710529771

  TX

  Medicare reassignment
• Houston Vamc

  • Department of Veterans Affairs (VA) Pharmacy
  • Lufkin, TX
  • NPI 1528222551
  NPD

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

{
    "created_epoch": "1388448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1972924496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LIBERTY ST",
            "address_2": "SUITE 800",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021434",
            "telephone_number": "502-367-3360",
            "fax_number": "502-367-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2206 N JOHN REDDITT DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759041776",
            "telephone_number": "936-671-4300",
            "fax_number": "936-671-4323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "THANH-DIU",
        "middle_name": "THI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-31",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2162",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "E9052",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Peikert, M.S. CCC/SLP
• Jaclyn Pena
• Lauren Elaine Penn, DPT, PT
• Hilario Perez Jr., PHARMD
• Quang Pham, D.O.
• Courtney Michelle Phillips, FNP
• Marisa Jon Phillips, LPC/NCC
• Misty Rae Phillips, FNP
• Monica Lindsey Phillips, RDMS, RVT
• Teresa Phillips, OTR

• Physician Assistant in Lufkin, TX
• Providers in Lufkin, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; 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.