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Individual

DR. GERALD D PHILLIPS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
3030 E 29TH ST, SUITE 106, BRYAN, TX 77802-2757
(979) 731-8446
(979) 731-8275
Mailing address
3030 E 29TH STREET, SUITE 106, BRYAN, TX 77802-2740
(979) 731-8446
(979) 731-8275

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
02145T
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
112311903
TX
01
16110
SPECTERA
TX
01
16258
SCOTT & WHITE
TX
01
3750
BLOCK VISION
TX
01
54812
DAVIS VISION
TX
01
59496
SAFEGUARD
TX
01
6271
AVESIS
TX
01
80323E
BLUE CROSS BLUE SHIELD
TX
01
TX2145
EYEMED
TX
Enumeration date
07/31/2006
Last updated
09/02/2008
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