Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kevin Loc Van Pham

Individual provider Physician Assistant · NPI 1184497505

Kevin Loc Van Pham is a Physician Assistant in Dallas, Texas. Qualified in 2023, 3 years ago. Practices with Houston Northwest Radiology Assn, a 31-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
3
Licensed in
TX
In the registry since
2023
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Practice location Address checks out

5323 Harry Hines Blvd Stop 7200
Dallas, TX 75390-9090
Phone: (214) 648-1701
Fax: (214) 648-1003
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA17517 (TX)

Record details

NPI number1184497505
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedNovember 7, 2023
Last updated in NPPESApril 2, 2024
Certification dateApril 2, 2024
Mailing address5323 Harry Hines Blvd Stop 7200, Dallas, TX 75390-9090

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Houston Northwest Radiology Assn — 31 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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