Individual
PEGGY MARIE PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN-BC, ANP-C
Contact information
Practice address
17448 HIGHWAY 3, SUITE 136, WEBSTER, TX 77598-4197
(281) 338-4443
(281) 338-8821
Mailing address
17448 HIGHWAY 3, SUITE 136, WEBSTER, TX 77598-4141
(281) 338-4443
(281) 338-8821
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
1010004
TX
363LA2200X
Adult Health Nurse Practitioner
Primary
518144
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134429046
BLUE CROSS BLUE SHIELD
TX
05
—
280521001
—
TX
05
—
280521002
—
TX
05
—
280521003
—
TX
05
—
280521004
—
TX
01
—
832N36
BLUE CROSS BLUE SHIELD
TX
01
—
P00988009
RAILROAD MEDICARE
TX
01
—
P01197024
MEDICARE RR
TX
Enumeration date
10/26/2010
Last updated
08/26/2016
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