Truc Inthaphom, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

R3236 Issued in TX

Practice address

27700 Northwest Fwy Ste 440
Cypress, TX 77433-6767

Phone

(832) 334-4011

Fax

(832) 334-4009

NPI assigned

May 15, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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

State licenses

Practice roles

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

• Blue Fish Pediatrics, L.L.P.

  • Pediatrics Physician
  • Houston, TX
  • NPI 1891884508

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1400112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1982015616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27700 NORTHWEST FWY STE 440",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774336767",
            "telephone_number": "832-334-4011",
            "fax_number": "832-334-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27700 NORTHWEST FWY STE 440",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774336767",
            "telephone_number": "832-334-4011",
            "fax_number": "832-334-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INTHAPHOM",
        "first_name": "TRUC",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-15",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "R3236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Infinite Health PLLC
• Inneresilience Gym, PLLC
• Innova Mind and Body
• Innova Sleep and Diagnostic Center
• Integrative Behavioral Health and Wellness, Inc
• Invictus Chiropractic PLLC
• Invictus Health LLC
• Iodds, Inc.
• Wajiha Iqbal, MD
• Brittany E Irvine

• Pediatrics Physician in Cypress, TX
• Providers in Cypress, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; 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.