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Individual

BAO QUANG PHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
12221 N MOPAC EXPY, AUSTIN, TX 78758
(314) 724-2766
Mailing address
11509 ERIC HEIDEN CT, AUSTIN, TX 78748-2019
(314) 724-2766

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
34.012393
OH
207P00000X
Emergency Medicine Physician
Primary
R5625
TX

Other

Enumeration date
05/16/2014
Last updated
11/21/2019
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