Individual
JESSICA PHI-PHUNG CO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-3916
(214) 648-2240
(214) 648-9207
Mailing address
5323 HARRY HINES BLVD, DALLAS, TX 75390-9055
(214) 648-2240
(214) 648-9207
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PA14282
TX
363AS0400X
Surgical Physician Assistant
PA14282
TX
Other
Enumeration date
02/26/2021
Last updated
06/21/2022
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