Organization
PETER T PHAM OD, PLLC
Active
Other names
Dr. Peter T Pham & Associates
Organization subpart
No
Provider details
NPI number
Authorized official
PETER PHAM O.D. (OPTOMETRIST)
(571) 248-6246
Entity
Organization
Contact information
Practice address
14044 PROMENADE COMMONS STREET, GAINESVILLE, VA 20155-4072
(571) 248-6246
(571) 248-6248
Mailing address
8300 SUDLEY RD, STE I-6, MANASSAS, VA 20109-3458
(703) 257-7580
(703) 257-1455
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618002204
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003155946
NPI
VA
Enumeration date
10/10/2016
Last updated
10/21/2016
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