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Individual

MR. THANH PHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
APRN

Contact information

Practice address
3447 RENNER RD STE 120, PLANO, TX 75074-0051
(469) 384-2989
(469) 666-8180
Mailing address
3447 RENNER RD STE 120, PLANO, TX 75074-0051
(469) 384-2989
(469) 666-8180

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1057298
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1057298
TX

Other

Enumeration date
10/20/2021
Last updated
10/02/2023
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