Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0122X | Plastic and Reconstructive Surgery | MD2016-0477 | NM |
Y | 2086S0122X | Plastic and Reconstructive Surgery | R5453 | TX |
NPI | 1134381965 |
---|---|
Provider Name | Dr. Paul M Phillips |
First Address | El Paso, TX 79912-5540 |
Second Address | El Paso, TX 79912-5540 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2008 |
Last Update Date | 23/08/2019 |