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Organization
TQP DENTISTRY PA
Active
Organization
TQP DENTISTRY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THIEN QUOC PHAM DDS (PRESIDENT)
(646) 305-7069
Entity
Organization
Contact information
Practice address
1909 N MAIN ST STE 107, PEARLAND, TX 77581-3369
(646) 305-7069
Mailing address
10223 BROADWAY ST STE P-248, PEARLAND, TX 77584-7880
(646) 305-7069
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
23502
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649465659
PROVIDER NPI NUMBER
TX
05
—
189843901
—
TX
01
—
23502
DENTAL LICENSE NUMBER
TX
01
—
G0154523
TEXAS DEPARTMENT OF PUBLIC SAFETY CONTROLLED SUBSTANCE NUMBER
TX
Enumeration date
10/22/2014
Last updated
03/07/2023
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