Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | H5945 | TX |
N | 208600000X | Surgeon | H5945 | TX |
Y | 2086S0122X | Plastic and Reconstructive Surgery | H5945 | TX |
NPI | 1144392820 |
---|---|
Provider Name | Linda G Phillips |
First Address | Galveston, TX 77555-5302 |
Second Address | Galveston, TX 77555-5302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2006 |
Last Update Date | 28/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E34178 | (02) | TX |