Individual
MR. DERALD PHILLIPS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1901 MEDI PARK DR STE 2050, AMARILLO, TX 79106-2109
(806) 355-3352
Mailing address
3605 PORTLAND AVE, AMARILLO, TX 79118-8197
(217) 918-0207
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA12454
TX
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
08/17/2018
Last updated
05/15/2019
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