IndividualActive
Jack Phan, M.D., PH.D.
NPI 1205150893 · Therapeutic Radiology Physician · Houston, TX
Provider details
- NPI number
- 1205150893
- Entity type
- Individual
- Primary specialty
- Therapeutic Radiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D., PH.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- N1835 (TX)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1515 Holcombe Blvd
Houston, TX 77030-4000
Phone: (713) 792-6161
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 4439
Houston, TX 77210-4439
Registry dates
- Enumerated
- 2010-03-25
- Last updated
- 2024-10-03
- Certified
- 2024-10-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.