Individual
DR. DANIEL HUBBARD PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
321 S FANNIN AVE, TYLER, TX 75702-7321
(903) 593-0987
(903) 592-3309
Mailing address
321 S FANNIN AVE, TYLER, TX 75702-7321
(903) 593-0987
(903) 592-3309
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0538
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119886304
—
TX
01
—
480026505
MEDICARE RAILROAD
TX
Enumeration date
08/24/2005
Last updated
07/29/2010
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