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General NPI Number Information
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NPI Number | 1598736290
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Entity Type | Individual
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Provider Name | JAMES RICHARD PHELAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1290 HERCULES AVE WYLE LABORATORIES
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City | HOUSTON
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State | TX
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Zip | 77058-2749
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Country | US
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Telephone | 281-212-1402
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Fax |
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Provider Business Mailing Address
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Address Line | 376 WOODWARD CT
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City | BIRMINGHAM
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State | AL
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Zip | 35242-6040
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Country | US
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Telephone | 850-712-6211
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Fax |
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 00027184
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License Number State | AL
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