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Individual

MINI M PHILIP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
GNP

Contact information

Practice address
3531 TOWN CENTER BLVD S, SUITE 101, SUGAR LAND, TX 77479-2590
(281) 491-3225
(281) 491-1702
Mailing address
3531 TOWN CENTER BLVD S, SUITE 101, SUGAR LAND, TX 77479-2590
(281) 491-3225
(281) 491-1702

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
687788
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
687788
LICENSE
TX
Enumeration date
05/16/2011
Last updated
05/16/2011
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