Tiny Phan
NPI 1104644467ActiveIndividual· Physician Assistant· Amarillo, TX
Physician Assistant in Amarillo, Texas, trained at University of Oklahoma College of Medicine (class of 2025). Enrolled in Medicare as practitioner - physician assistant.
Overview
| NPI | 1104644467 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Sep 26, 2024 |
| Last updated in NPPES | Jan 21, 2026 |
| Certified by provider | Jan 21, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | PA19842 | TX |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (TX) |
|---|
Education and affiliations
| Medical school | University of Oklahoma College of Medicine |
|---|---|
| Graduation year | 2025 |
| Medicare specialty | Physician Assistant |
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 60 physician assistants in Amarillo · All physician assistants in Texas