Individual
DR. KELLEY J PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3500 GASTON AVE, DALLAS, TX 75246-2096
(214) 820-2505
Mailing address
4409 VERDE LANE, FRISCO, TX 75034
(469) 287-2750
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M1293
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176422707
—
TX
05
—
176422708
—
TX
01
—
8H4406
BCBS
TX
Enumeration date
05/26/2006
Last updated
04/16/2014
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