| Minh Phan Dds Pa | |
|
123 W Southmore Pasadena TX 77502 | |
| (713) 473-0058 | |
| (713) 473-0636 |
| Full Name | Minh Phan Dds Pa |
|---|---|
| Speciality | Dentist |
| Location | 123 W Southmore, Pasadena, Texas |
| Authorized Official Name and Position | Minh H Phan (PRESIDENT) |
| Authorized Official Contact | 7134737223 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Minh Phan Dds Pa 905 Southmore Pasadena TX 77502 Ph: () - | Minh Phan Dds Pa 123 W Southmore Pasadena TX 77502 Ph: (713) 473-0058 |
| NPI Number | 1659596641 |
|---|---|
| Provider Enumeration Date | 04/16/2007 |
| Last Update Date | 11/08/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659596641 | NPI | - | NPPES |
| 180693701 | Medicaid | TX | |
| G6010102 | Other | TX | DELTA DENTAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 19016 (Texas) | Primary |
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