Provider Demographics
NPI:1447549068
Name:PASAO-PHAM, NICOLE PRISCILLA (CRNP)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:PRISCILLA
Last Name:PASAO-PHAM
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 FANNIN ST STE 2070
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1541
Mailing Address - Country:US
Mailing Address - Phone:713-486-7747
Mailing Address - Fax:713-486-8088
Practice Address - Street 1:7777 SOUTHWEST FWY STE 840
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1812
Practice Address - Country:US
Practice Address - Phone:713-486-8080
Practice Address - Fax:713-486-8090
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011151363LA2100X
TXAP145245363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care