Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | M7522 | TX |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | M7522 | TX |
N | 207XS0106X | Orthopaedic Hand Surgeon | M7522 | TX |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | M7522 | TX |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | M7522 | TX |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | M7522 | TX |
N | 207XX0801X | Orthopaedic Trauma Surgeon | M7522 | TX |
NPI | 1700075637 |
---|---|
Provider Name | Dr. Christopher Ian Phelps |
First Address | San Antonio, TX 78258-4352 |
Second Address | San Antonio, TX 78258-4352 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2007 |
Last Update Date | 06/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
193287305 | (05) | TX |