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Individual

RYAN PHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O

Contact information

Practice address
621 SW JOHNSON AVE, SUITE C, BURLESON, TX 76028-5833
(817) 766-7421
(817) 447-8100
Mailing address
621 SW JOHNSON AVE, BURLESON, TX 76028-5833
(817) 766-7421
(817) 447-8100

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
P1128
TX
207NS0135X
Procedural Dermatology Physician
P1128
TX

Other

Enumeration date
05/04/2010
Last updated
11/28/2017
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