Organization
THERESA S. PHILLIPS, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA S PHILLIPS MD (OWNER)
(830) 257-1785
Entity
Organization
Contact information
Practice address
710 WATER ST, #602, KERRVILLE, TX 78028-5329
(830) 257-1785
(830) 257-1786
Mailing address
PO BOX 293279, KERRVILLE, TX 78029-3279
(830) 257-1785
(830) 257-1786
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
J8714
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113481903
—
TX
Enumeration date
04/06/2006
Last updated
07/10/2008
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