DR. KHUONG DINH PHAN (NPI# 1033119540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033119540 |
| Entity Type | Individual |
| Full Name | DR. KHUONG DINH PHAN |
| Credential | D.O. |
| Practice Address |
920 Highway 287 N Suite 308 Mansfield TX 76063-2627 |
| Mailing Address |
8553 N Beach St Pmb 296 Fort Worth TX 76244-4919 |
| Practice Telephone | 8174737197 |
| Practice Fax Number | 8174737198 |
| Mailing Telephone | 8174737197 |
| Mailing Fax Number | 8174737198 |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2010-11-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 7520 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS PIN | 8X9320 | 01 | |
| MEDICARE RAILROAD GROUP | DG4235 | 01 | |
| MEDICARE RAILROAD PTAN | P00434893 | 01 | |
| TX | 180563202 | 05 |
| Street Address |
920 HIGHWAY 287 N SUITE 308 |
| City | MANSFIELD |
| State | TX |
| Zip Code | 76063-2627 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225033574 | Randall Wagman | Family Medicine | 920 Highway 287 N, Ste 300, Mansfield, TX 76063-2627 | 2005-06-14 |
| 1932374253 | Arlington Primary Medicine Pllc | Family Medicine | 920 Highway 287 N, Ste 300, Mansfield, TX 76063-2627 | 2008-04-28 |
| 1710006556 | Khuong Phan, D.o., P.a. | Internal Medicine | 920 Highway 287 N, Suite 308, Mansfield, TX 76063-2627 | 2007-03-29 |
| 1437245313 | West Lpn, Inc. | Internal Medicine | 920 Highway 287 N, Suite 300, Mansfield, TX 76063-2627 | 2006-10-05 |
| 1639154602 | West Lpn Inc | Internal Medicine | 920 Highway 287 N, Suite 300, Mansfield, TX 76063-2627 | 2005-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316558349 | Lindsey Vandyke, D.o. Pllc | Internal Medicine | 3150 E Broad Street, Ste 100, Mansfield, TX 76063 | 2020-08-13 |
| 1942819867 | Jennifer Que Chau Nguyen | Pharmacist | 980 U.S. 287 Frontage Rd #287, Mansfield, TX 76063 | 2020-07-27 |
| 1194346890 | Ana Maria Gonzalez | Dentist | 1600 Us Highway 287, Suite 102, Mansfield, TX 76063 | 2020-05-04 |
| 1245869080 | Stateserv Medical of Texas, LLC | Durable Medical Equipment & Medical Supplies | 7941 Rodeo Trail, Mansfield, TX 76063 | 2020-04-03 |
| 1649802232 | Mary Puanani Kamai | Nurse Practitioner | 1301 E. Debbie Lane, Suite 102 #1405, Mansfield, TX 76063 | 2020-02-11 |
| 1770123028 | Gladys Vera Nfodzo | Nurse Practitioner | 901 W. Broad St, Mansfield, TX 76063 | 2020-01-14 |
| 1669011300 | Alexa Smith | Nurse Practitioner | 2800 E Broad St #304, Mansfield, TX 76063 | 2019-12-28 |
| 1477190437 | Mel Rockwall LLC | Optometrist | 1701 East Broad Street, Ste 109, Mansfield, TX 76063 | 2019-12-09 |
| 1376185512 | Daniel Max & Marcandrea LLC | Optometrist | 1701 East Broad St., Ste 109, Mansfield, TX 76063 | 2019-10-09 |
| 1861046385 | Lacey Eaton | Counselor | 805 Killian Dr, Mansfield, TX 76063 | 2019-08-01 |
| Find all providers in zip 76063 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639606353 | Maria Lorena Martinez Rojas | Internal Medicine | 770 Balgreen Dr Fl 1, Mansfield, OH 44906-4106 | 2017-05-11 |
| 1659736957 | Vital Healthcare Solutions | Internal Medicine | 76 Cherry Ridge Dr, Mansfield, PA 16933-8446 | 2015-12-31 |
| 1366857963 | Jiaul Ahsan Pllc | Internal Medicine | 99 Regency Pkwy Ste 305, Mansfield, TX 76063-7820 | 2014-06-23 |
| 1710329040 | Questcare Medical Clinics Pllc | Internal Medicine | 1001 Matlock Rd Ste 101, Mansfield, TX 76063-3443 | 2013-07-29 |
| 1285992602 | Masud Habibullah | Internal Medicine | 17 Evans Cir, Mansfield, MA 02048-1514 | 2012-04-24 |
| 1063730505 | Jaremy Emer James | Internal Medicine | 252 Matlock Road, Suite 130, Mansfield, TX 76063 | 2010-05-07 |
| 1548419120 | Keith D Rigsby, Md, Pa | Internal Medicine | 4105 Greenwood Way, Mansfield, TX 76063-5563 | 2008-09-18 |
| 1164690111 | Denise Kay Bruckerhoff | Internal Medicine | 1788 Highway 157 N Ste 103, Mansfield, TX 76063-3929 | 2008-02-12 |
| 1609053412 | Newlands Inpatient Services | Internal Medicine | 2700 East Broad St., Mansfield, TX 76063 | 2008-01-23 |
| 1669676136 | Sneha Patel | Internal Medicine | 2800 E Broad St Ste 318, Mansfield, TX 76063-6413 | 2007-06-11 |
| Find all providers in MANSFIELD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.