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General NPI Number Information
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NPI Number | 1144373689
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Entity Type | Individual
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Provider Name | MICHAEL DON PHILLIPS OD
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Gender | Male
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 07/13/2009
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Provider Practice Location Address
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Address Line | 811 N CENTRAL EXPY SUITE 1005
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City | PLANO
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State | TX
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Zip | 75075-8815
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Country | US
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Telephone | 972-633-5000
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Fax | 972-423-0454
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Provider Business Mailing Address
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Address Line | 811 N CENTRAL EXPY SUITE 1005
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City | PLANO
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State | TX
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Zip | 75075-8815
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Country | US
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Telephone | 972-633-5000
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Fax | 972-423-0454
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 02498T
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License Number State | TX
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