Individual
DR. MICHAEL J. PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-8800
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
K6237
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0386682-01
—
TX
01
—
0486375-01
CSHCN
TX
01
—
300115742
RR/MEDICARE
TX
01
—
81351K
BLUE SHIELD
TX
Enumeration date
03/31/2006
Last updated
01/05/2021
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