KEVIN LOC VAN PHAM – Physician Assistant, NPI 1184497505

KEVIN LOC VAN PHAM is a healthcare provider. based in Dallas, Texas. specializing in PHYSICIAN ASSISTANT. They hold a License No. PA17517 (TX). The NPI Number for KEVIN LOC VAN PHAM is 1184497505

Main info

Male
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
KEVIN LOC VAN PHAM
NPI
1184497505
Phone
(214) 648-1701
Address
5323 HARRY HINES BLVD STOP 7200
Enumeration Date
7 November 2023
Last Update Date
2 April 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2814405158
Graduation Year
2023 (3 years ago)
PAC ID
2567993934
Group Practice PAC ID
5092799775
Professional Enrollment ID
I20241009002873
Address ID
TX770902903HO800XXDRXX306
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

8,491 PHYSICIAN ASSISTANT in TX

Provider Addresses for KEVIN LOC VAN PHAM

  • 5323 HARRY HINES BLVD STOP 7200

    DALLAS, TX 753909090

    Phone: (214) 648-1701

    Fax: (214) 648-1003

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-10-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241009002873IPhysician AssistantTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 75390)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5092799775View full group profile
NameSpecialtyState
Diagnostic RadiologyTX
Diagnostic RadiologyTX
Interventional RadiologyMA
Physician AssistantFL
-TX
Diagnostic RadiologyTX
Diagnostic RadiologyTX
Diagnostic RadiologyTX
Diagnostic RadiologyTX
Interventional RadiologyTX

Reviews

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Frequently asked questions

What is KEVIN LOC VAN PHAM's NPI number?
KEVIN LOC VAN PHAM's NPI is 1184497505 — the number used across U.S. healthcare to identify this provider.
Active or inactive — what applies to KEVIN LOC VAN PHAM?
You should see KEVIN LOC VAN PHAM as active in CMS-hosted NPPES data.
How would a patient describe KEVIN LOC VAN PHAM's focus?
For KEVIN LOC VAN PHAM, the primary taxonomy reads as Physician Assistant. Clinical services aligned with this taxonomy classification.
Where in Texas is KEVIN LOC VAN PHAM registered?
Use Dallas, Texas as the headline location for KEVIN LOC VAN PHAM here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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