Provider Demographics
NPI:1427277151
Name:THE HUNG PHAM,D.D.S., P.A.
Entity type:Organization
Organization Name:THE HUNG PHAM,D.D.S., P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THE
Authorized Official - Middle Name:HUNG
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:979-297-3882
Mailing Address - Street 1:145 OYSTER CREEK DR
Mailing Address - Street 2:STE 8
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-4197
Mailing Address - Country:US
Mailing Address - Phone:979-297-3882
Mailing Address - Fax:979-297-4497
Practice Address - Street 1:145 OYSTER CREEK DR
Practice Address - Street 2:STE 8
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-4197
Practice Address - Country:US
Practice Address - Phone:979-297-3882
Practice Address - Fax:979-297-4497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX196551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty