Individual
DEMETRIA D PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5215 FM 1960 RD W, HOUSTON, TX 77069-4414
(337) 570-0712
Mailing address
10144 WILD HOLLOW LN, HOUSTON, TX 77088-2150
(337) 570-0712
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
1602217
TX
405300000X
Prevention Professional
1602217
TX
Other
Enumeration date
08/31/2022
Last updated
08/31/2022
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