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General NPI Number Information
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NPI Number | 1215872908
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Entity Type | Organization
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Legal Business Name | PHOENIX MEDICAL SPA PLLC
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Dates
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Enumeration Date | 04/21/2026
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Last Update Date | 04/21/2026
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Provider Practice Location Address
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Address Line | 3006 WILD RIVER RD
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City | MELISSA
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State | TX
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Zip | 75454
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Country | US
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Telephone | 210-740-4052
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Fax |
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Provider Business Mailing Address
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Address Line | 6800 WEISKOPF AVE STE 150
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City | MCKINNEY
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State | TX
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Zip | 75070-5340
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO/FOUNDER
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Name | DR. BERTINA MARIE HOOKS
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Credential | MD
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Telephone | 210-740-4052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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