Organization
ORIGINS BIRTH SERVICES, LLC
Active
Other names
Origin's Birth and Wellness Collective
Organization subpart
No
Provider details
NPI number
Authorized official
GINA RACHEL PHILLIPS CPM, LM (MIDWIFE)
(214) 680-0956
Entity
Organization
Contact information
Practice address
10340 ALTA VISTA RD, FORT WORTH, TX 76244-6500
(817) 349-6005
(817) 768-6940
Mailing address
10340 ALTA VISTA RD STE 1A, FORT WORTH, TX 76244-6500
(817) 349-6005
(817) 768-6940
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
—
—
261QB0400X
Birthing Clinic/Center
150037
TX
Other
Enumeration date
04/03/2014
Last updated
12/11/2014
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