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Organization
GEORGIA M PHILLIPS CCC SLP LLC
Active
Organization
GEORGIA M PHILLIPS CCC SLP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGIA M PHILLIPS CCC SLP (SOLE OWNER)
(956) 793-3252
Entity
Organization
Contact information
Practice address
2600 OLD ALICE RD STE D, BROWNSVILLE, TX 78521-1456
(956) 982-8578
(956) 350-8999
Mailing address
401 TESORO AVE, RANCHO VIEJO, TX 78575-9539
(956) 793-3252
(956) 350-8999
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10313
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366468050
PERSONAL NPI
TX
05
—
161372101
—
TX
Enumeration date
05/08/2015
Last updated
05/08/2015
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