Individual
LESLIE ANNE PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
855 MONTGOMERY ST, DEPT OF OB/GYN, FORT WORTH, TX 76107-2553
(817) 735-2198
(817) 735-0687
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
(817) 735-0400
(817) 735-0111
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
K6495
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148805802
—
TX
01
—
8AA712
BCBS
TX
01
—
P00913471
RAILROAD MEDICARE
TX
Enumeration date
06/28/2006
Last updated
05/23/2011
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