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General NPI Number Information
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NPI Number | 1063592012
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Entity Type | Organization
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Legal Business Name | JASON ROBERT PHILLIPS MD PA
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 08/27/2009
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Provider Practice Location Address
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Address Line | 615 CAMELOT DR
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City | HARLINGEN
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State | TX
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Zip | 78550-8472
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Country | US
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Telephone | 956-428-5700
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Fax | 956-428-5701
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Provider Business Mailing Address
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Address Line | 615 CAMELOT DR
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City | HARLINGEN
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State | TX
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Zip | 78550-8472
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Country | US
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Telephone | 956-428-5700
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Fax | 956-428-5701
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. JASON ROBERT PHILLIPS
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Credential | MD
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Telephone | 956-428-5700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | L8473
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License Number State | TX
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