Individual
PHILLIP C. PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5445 LA BRANCH ST STE 100, HOUSTON, TX 77004-6835
(713) 973-7246
Mailing address
5445 LA BRANCH ST STE 100, HOUSTON, TX 77004-6835
(713) 973-7246
(832) 553-1337
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
N2242
TX
208VP0000X
Pain Medicine Physician
N2242
TX
208VP0014X
Interventional Pain Medicine Physician
N2242
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
179470307
—
TX
Enumeration date
10/12/2006
Last updated
07/21/2022
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