Organization
ENT AND ALLERGY CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNE PHAM MD (PRESIDENT)
(940) 627-7997
Entity
Organization
Contact information
Practice address
1600 W BUSINESS 380, SUITE A, DECATUR, TX 76234-3281
(940) 627-7997
(940) 627-7416
Mailing address
1600 W BUSINESS 380, SUITE A, DECATUR, TX 76234-3281
(940) 627-7997
(940) 627-7416
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0071LT
BCBS
TX
05
—
1669590
—
TX
Enumeration date
04/26/2006
Last updated
06/06/2019
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