Provider Demographics
NPI:1205282480
Name:PHAM, CHRISTINE (RDCS)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:PHAM
Suffix:
Gender:F
Credentials:RDCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11240 FM 1960 WEST
Mailing Address - Street 2:ST 406 - A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065
Mailing Address - Country:US
Mailing Address - Phone:832-451-0118
Mailing Address - Fax:
Practice Address - Street 1:11240 FM 1960 WEST
Practice Address - Street 2:ST 406 - A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065
Practice Address - Country:US
Practice Address - Phone:832-451-0118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-06
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX187257246W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Cardiology