1. Home
  2. Directory
  3. Texas
  4. Amarillo
  5. Physician Assistant
  6. NPI Profile

TINY PHAN
NPI 1104644467
Physician Assistant in Amarillo, TX

Active since September 26, 2024PECOS Enrolled
2021 EVERGREEN ST, AMARILLO, TX 79107(806) 236-2321 Get Directions Write a Review

NPPES record last updated: January 21, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 21, 2026, Sep 26, 2024 (2 updates tracked since 2024).

About Tiny Phan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TINY PHAN (NPI 1104644467) is an individual physician assistant in Amarillo, Texas, licensed in Texas (PA19842) and active in the NPI registry since September 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104644467
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameTINY PHAN
Location Address2021 EVERGREEN STAmarillo, TX 79107-7551
Mailing Address2021 Evergreen StAmarillo, TX 79107-7551 · (806) 236-2321
Phone(806) 236-2321
Sole ProprietorNo
Enumeration DateSeptember 26, 2024
Last NPPES UpdateJanuary 21, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 21, 2026
✔ NPI 1104644467 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in TX · PA19842
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
2021 EVERGREEN ST, Amarillo, TX 79107
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tiny Phan is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 79107 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tiny Phan's NPI number?

The NPI number for Tiny Phan is 1104644467. It was assigned to this individual provider in the NPPES registry on September 26, 2024.

Where is Tiny Phan located?

Tiny Phan practices at 2021 Evergreen St, Amarillo, TX 79107. The listed phone number is (806) 236-2321.

What is Tiny Phan's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Tiny Phan enrolled in Medicare?

Yes. Tiny Phan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Tiny Phan was last updated on January 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.