Provider Demographics
NPI:1366090938
Name:PHAM, QUYNH GIAO N (APRN- FNP)
Entity type:Individual
Prefix:
First Name:QUYNH GIAO
Middle Name:N
Last Name:PHAM
Suffix:
Gender:F
Credentials:APRN- FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 WRIGHT ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-4731
Mailing Address - Country:US
Mailing Address - Phone:817-801-5704
Mailing Address - Fax:
Practice Address - Street 1:925 WRIGHT ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-4731
Practice Address - Country:US
Practice Address - Phone:818-801-5704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-28
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142427363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily