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Individual

CHARLES W PHILLIPS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
4311 W WADLEY AVE, MIDLAND, TX 79707-5457
(432) 689-0323
(432) 689-2916
Mailing address
4311 W WADLEY AVE, MIDLAND, TX 79707-5457
(432) 689-0323
(432) 689-2916

Taxonomy

Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
2745TG
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
019790701
TX
Enumeration date
07/20/2006
Last updated
07/30/2008
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