Individual
JASON RYAN PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.P., C.P. CFTS
Contact information
Practice address
7619 UNIVERSITY AVE, LUBBOCK, TX 79423-2125
(806) 799-1518
(806) 799-5462
Mailing address
7619 UNIVERSITY AVE, LUBBOCK, TX 79423-2125
(806) 799-1518
(806) 799-5462
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
252
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145567702
—
TX
Enumeration date
04/13/2012
Last updated
07/30/2024
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