Doctor Name: | MS. TERRA R PHILLIPS |
NPI Number: | 1154501757 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | PA05101 |
Business Practice Address: | 1120 Medical Plaza Dr Suite 150 Shenandoah, TX - 773803242 |
Business Phone Number: | 7138975900 |
Business Fax Number: | 7138972202 |
Mailing Address: | 6400 Fannin St Ste 2070, HOUSTON |
State: | TX |
Postal Code: | 770301541 |
Phone Number: | 7137046731 |
Fax Number: | 7137046889 |
NPI Enumeration Date: | 11/12/2007 |
NPI Last Update Date: | 02/01/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA05101 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |