Provider Demographics
NPI:1366753279
Name:PHAN, CECILE LOCCHI (MD)
Entity type:Individual
Prefix:DR
First Name:CECILE
Middle Name:LOCCHI
Last Name:PHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6550 FANNIN ST STE 1801
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2744
Mailing Address - Country:US
Mailing Address - Phone:713-798-7411
Mailing Address - Fax:713-798-1486
Practice Address - Street 1:6550 FANNIN ST STE 1801
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2744
Practice Address - Country:US
Practice Address - Phone:713-798-7411
Practice Address - Fax:713-798-1486
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-24
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN59432084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB110688Medicare PIN
TXTXB117499Medicare PIN