Individual
DR. CHI M PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
500 S HENDERSON ST STE 200, FORT WORTH, TX 76104-2154
(174) 131-5008
(817) 413-1499
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 437-9605
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M0222
TX
207RH0003X
Hematology & Oncology Physician
Primary
M0222
TX
207RX0202X
Medical Oncology Physician
M0222
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163293801
—
TX
05
—
196293802
—
TX
05
—
196293803
—
TX
01
—
8AQ007
BCBSTX
TX
01
—
P00662593
RAILROAD MEDICARE
TX
Enumeration date
03/21/2007
Last updated
12/09/2021
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