Individual
DR. BENNY POTHEN PHILLIPS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3621 22ND ST, SUITE 100, LUBBOCK, TX 79410-1301
(806) 796-1317
(806) 796-0426
Mailing address
3621 22ND ST, SUITE 100, LUBBOCK, TX 79410-1301
(806) 796-1317
(806) 796-0426
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
F2851
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84141N
BLUE CROSS BLUE SHIELD
TX
Enumeration date
09/13/2005
Last updated
07/08/2007
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