Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YX0007X | Plastic Surgeon (Head & Neck) | R2005 | TX |
NPI | 1407013279 |
---|---|
Provider Name | Dr. Brett T Phillips |
First Address | Houston, TX 77210-4439 |
Second Address | Houston, TX 77030 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2008 |
Last Update Date | 27/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
381201801 | (05) | TX |
381201802 | MEDICAID CSHCN (01) | TX |