Individual
JAIDAN PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 702-3431
Mailing address
4633 HAVERHILL LN, CORPUS CHRISTI, TX 78411-4937
(361) 737-1614
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1013292
TX
Other
Enumeration date
01/10/2026
Last updated
05/10/2026
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