Individual
MINI PHILIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390
(469) 767-6638
Mailing address
PO BOX 845347, DALLAS, TX 75284-7208
(469) 767-6638
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP135865
TX
363LA2200X
Adult Health Nurse Practitioner
AP135865
TX
Other
Enumeration date
03/01/2018
Last updated
08/06/2024
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