Individual
DR. PHILLIP CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
2086S0129X
Vascular Surgery Physician
Primary
E4257
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
824099
BCBS OF TEXAS
TX
Enumeration date
08/02/2006
Last updated
07/09/2007
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