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General NPI Number Information
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NPI Number | 1477045151
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Entity Type | Organization
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Legal Business Name | PAUL PHILLIPS III, M.D., P.A.
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Dates
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Enumeration Date | 05/30/2018
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Last Update Date | 07/31/2018
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Provider Practice Location Address
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Address Line | 1305 N MILAM ST
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City | FREDERICKSBURG
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State | TX
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Zip | 78624
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Country | US
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Telephone | 830-997-7626
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Fax |
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Provider Business Mailing Address
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Address Line | 10759 PRESTON RD STE 200
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City | DALLAS
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State | TX
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Zip | 75230-3806
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Country | US
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Telephone | 972-480-3400
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Fax |
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | NORMAN WINLAND
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Credential |
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Telephone | 972-480-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | H2688
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License Number State | TX
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