MEDICARE: MRS. PAULA PHILLIPS OT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	110260	TX

General Provider Information

NPI Number	:	1942758685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PAULA PHILLIPS OT

Provider Business Mailing Address
First Line	:	1719 ANGEL PKWY STE 400
Second Line	:	# 156
City	:	ALLEN
State	:	TX
Zip	:	75002-2697
Country	:	US
Telephone Number	:	469-629-3762
Fax Number	:

Provider Business Practice Location Address
First Line	:	3800 W PARK BLVD
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75075-3542
Country	:	US
Telephone Number	:	972-612-1700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2016
Last Update Date	:	06/20/2025

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