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Individual

DR. MICHAEL STEPHEN PHILLIPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1301 W 7TH ST, SUITE # 121, FT WORTH, TX 76102-2651
(817) 348-0425
(817) 748-0425
Mailing address
1301 W 7TH ST, SUITE # 121, FT WORTH, TX 76102-2651
(817) 348-0425
(817) 748-0455

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
E4598
TX
207VG0400X
Gynecology Physician
E 4598
TX
208D00000X
General Practice Physician
Primary
E 4598
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
POQD231
TX
Enumeration date
07/10/2006
Last updated
09/15/2017
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