Organization
PREMIER PROVIDER HEALTH PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HAN NGOC PHAM M.D. (CEO)
(214) 274-1507
Entity
Organization
Contact information
Practice address
4316 JAMES CASEY ST STE B-100, AUSTIN, TX 78745-1142
(512) 444-4325
Mailing address
7314 CENTENARY AVE STE 700, DALLAS, TX 75225-4624
(214) 274-1507
(512) 354-1106
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
M0223
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187308502
—
TX
Enumeration date
06/04/2015
Last updated
06/21/2022
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