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Individual

KY D PHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
590 MEDICAL CENTER ROAD, FORT CAVAZOS, TX 76544
(512) 893-2835
Mailing address
590 MEDICAL CENTER ROAD, FORT CAVAZOS, TX 76544
(512) 893-2835

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0101277584
VA
208D00000X
General Practice Physician
01091111A
IN

Other

Enumeration date
04/10/2012
Last updated
11/25/2024
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