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Individual
THY ANH TUAN PHAN MAK
Active
Individual
THY ANH TUAN PHAN MAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA07114
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220114701
—
TX
01
—
847N07
BCBS
TX
01
—
P00964720
RR MEDICARE
TX
Enumeration date
03/25/2011
Last updated
02/19/2020
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