Provider Demographics
NPI:1184207938
Name:PHAM, TOMMY TAM (MD)
Entity type:Individual
Prefix:DR
First Name:TOMMY
Middle Name:TAM
Last Name:PHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5101 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4801
Mailing Address - Country:US
Mailing Address - Phone:210-358-3108
Mailing Address - Fax:210-702-6951
Practice Address - Street 1:5101 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4801
Practice Address - Country:US
Practice Address - Phone:210-358-3108
Practice Address - Fax:210-702-6951
Is Sole Proprietor?:No
Enumeration Date:2021-04-29
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU1111207P00000X, 208VP0014X
TXBP10075309207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine