Individual
MISS COBY J PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1010 W 40TH ST, AUSTIN, TX 78756-4010
(512) 459-8753
(512) 483-6807
Mailing address
1010 W 40TH ST, AUSTIN, TX 78756-4010
(512) 459-8753
(512) 483-6807
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA03814
TX
363AS0400X
Surgical Physician Assistant
Primary
PA03814
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
185754201
—
TX
01
—
8N8259
BCBS OF TEXAS
TX
Enumeration date
08/01/2006
Last updated
03/25/2016
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