MEDICARE: JOSEPH THEODORE PHILLIPS JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	F9951	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013983774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH THEODORE PHILLIPS JR. M.D.

Provider Business Mailing Address
First Line	:	6301 GASTON AVE
Second Line	:	SUITE 100 WEST TOWER
City	:	DALLAS
State	:	TX
Zip	:	75214-3922
Country	:	US
Telephone Number	:	214-827-3610
Fax Number	:	214-443-9640

Provider Business Practice Location Address
First Line	:	6301 GASTON AVE
Second Line	:	SUITE 100 WEST TOWER
City	:	DALLAS
State	:	TX
Zip	:	75214-3922
Country	:	US
Telephone Number	:	214-827-3610
Fax Number	:	214-443-9640

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	09/08/2010

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