Provider Demographics
NPI:1730234170
Name:PHAM, QUAN D (DC)
Entity type:Individual
Prefix:DR
First Name:QUAN
Middle Name:D
Last Name:PHAM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 W SPRING VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-4034
Mailing Address - Country:US
Mailing Address - Phone:214-226-2759
Mailing Address - Fax:972-238-0456
Practice Address - Street 1:208 W SPRING VALLEY RD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-4034
Practice Address - Country:US
Practice Address - Phone:214-226-2759
Practice Address - Fax:972-238-0456
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6746111NR0400X, 111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health
No111NR0400XChiropractic ProvidersChiropractorRehabilitation