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Individual

THINH PHU PHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
400 ROSALIND REDFERN GROVER PKWY STE 100, MIDLAND, TX 79701-5849
(432) 687-1949
(432) 687-4251
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 234-0813

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
A80413
CA
2085R0001X
Radiation Oncology Physician
Primary
M4444
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00250T
GROUP MEDICARE PTAN
TX
01
00251T
GROUP MEDICARE PTAN
TX
01
1477553477
GROUP NPI
01
1487887667
GROUP NPI
01
1590473-01
GROUP MEDICAID
TX
01
1590648-01
GROUP MEDICAID
TX
01
1700017449
GROUP NPI
01
1871594424
GROUP NPI
TX
Enumeration date
07/07/2006
Last updated
09/25/2025
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