Individual provider · Type 1 NPI

Jack Phan, MD, PhD

Therapeutic Radiology Physician · Houston, TX

NPI number 1205150893 Active

Practice location

1515 Holcombe Blvd
Houston, TX 77030-4000

Mailing address

PO Box 4439
Houston, TX 77210-4439

Specialties and licenses

TaxonomyCodeLicense
Therapeutic Radiology Physician Primary 2085R0203XN1835 (TX)

Therapeutic Radiology Physician: Therapeutic Radiology certificate name was changed to Radiation Oncology. Use Radiation Oncology.

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About NPI 1205150893

Jack Phan, MD, PhD's National Provider Identifier is 1205150893, issued on Mar 25, 2010. The primary taxonomy on file is Therapeutic Radiology Physician (2085R0203X), and the practice location is in Houston, TX. The record was last updated on Oct 3, 2024.