Provider Demographics
NPI:1033648183
Name:PHAM, TRAM MAI (OD)
Entity type:Individual
Prefix:DR
First Name:TRAM
Middle Name:MAI
Last Name:PHAM
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 MILLER RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-5531
Mailing Address - Country:US
Mailing Address - Phone:864-569-4915
Mailing Address - Fax:
Practice Address - Street 1:800 OXFORD EXCHANGE BLVD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:AL
Practice Address - Zip Code:36203-3465
Practice Address - Country:US
Practice Address - Phone:256-419-2002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-11
Last Update Date:2017-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-D77152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist