Individual
DR. THUC DUY PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
28 WILLIAM ST, GOUVERNEUR, NY 13642-1405
(315) 287-2811
Mailing address
514 ROZELLE AVE, SUGAR LAND, TX 77498-3080
(281) 772-7400
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
269123
NY
2084P0804X
Child & Adolescent Psychiatry Physician
R0297
TX
Other
Enumeration date
03/31/2011
Last updated
11/16/2021
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