Individual
PHILLIPS KIRK LABOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2201 WESTGATE PLAZA, GRAPEVINE, TX 76051
(817) 410-2030
(817) 251-6261
Mailing address
2201 WESTGATE PLAZA, GRAPEVINE, TX 76051
(817) 410-2030
(817) 251-6261
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
K7044
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15470333
PACIFICARE PIN
TX
01
—
3977274
CIGNA PIN
TX
01
—
5456201
AETNA PIN
TX
01
—
8A2214
BCBS PIN
TX
Enumeration date
05/17/2006
Last updated
06/22/2020
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