Healthcare Provider Details

I. General information

NPI: 1780833392
Provider Name (Legal Business Name): KATHY PHILLIPS R.EEG/EP T., CNIM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2008
Last Update Date: 04/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16131 N ELDRIDGE PKWY
TOMBALL TX
77377-9129
US

IV. Provider business mailing address

16131 N ELDRIDGE PKWY
TOMBALL TX
77377-9129
US

V. Phone/Fax

Practice location:
  • Phone: 281-970-5900
  • Fax: 281-970-5913
Mailing address:
  • Phone: 281-970-5900
  • Fax: 281-970-5913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: