Individual
AUGUSTINE PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
11601 S WESTERN AVE, OKLAHOMA CITY, OK 73170-5823
(405) 691-5208
Mailing address
11601 S WESTERN AVE, OKLAHOMA CITY, OK 73170-5823
(405) 691-5208
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
APA2479
OK
Other
Enumeration date
02/02/2015
Last updated
02/02/2015
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