Individual
STEPHEN W PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6550 FANNIN, SM749, HOUSTON, TX 77030
(713) 441-7465
Mailing address
6550 FANNIN ST, SM749, HOUSTON, TX 77030-2717
(713) 441-7465
(713) 790-2996
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
44379
MN
2085R0202X
Diagnostic Radiology Physician
Primary
N1068
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031638500
—
MN
05
—
200189301
—
TX
01
—
8BQ331
BLUE CROSS BLUE SHIELD
—
Enumeration date
12/30/2005
Last updated
06/10/2009
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