Individual
DR. PHILIP GAIL ITKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
Mailing address
PO BOX 847408, DALLAS, TX 75284-7408
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
13775
NE
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
N7706
TX
Other
Enumeration date
11/14/2006
Last updated
09/06/2011
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