# ALEXANDR VATTAMALA PHILIP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104328723
- **Authorized official:** MR. ALEXANDR VATTAMALA PHILIP (LICENSED PROFESSIONAL COUNSELOR)
- **Authorized official phone:** (214) 436-2272

## Contact information

- **Practice address:** 2301 OLYMPIA DR STE 100, FLOWER MOUND, TX 75028-1855
- **Practice address phone:** (214) 436-2272
- **Practice address fax:** (469) 464-9924
- **Mailing address:** 1400 VALLEY RIDGE BLVD APT 5107, LEWISVILLE, TX 75077-2998
- **Mailing address phone:** (214) 436-2272

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | 74513 | TX | Yes |

## Other

- **Enumeration date:** 02/28/2018
- **Last updated:** 02/28/2018