MEDICARE: DR. MOHAN P PHILIP 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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	L7111	TX
2	207RP1001X	Pulmonary Disease Physician	L7111	TX
3	207RS0012X	Sleep Medicine (Internal Medicine) Physician	L7111	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	:	1124093471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAN P PHILIP M.D

Provider Business Mailing Address
First Line	:	4215 JOE RAMSEY BLVD E
Second Line	:
City	:	GREENVILLE
State	:	TX
Zip	:	75401-7852
Country	:	US
Telephone Number	:	903-408-5834
Fax Number	:	903-408-5693

Provider Business Practice Location Address
First Line	:	4215 JOE RAMSEY BLVD E
Second Line	:
City	:	GREENVILLE
State	:	TX
Zip	:	75401-7852
Country	:	US
Telephone Number	:	903-408-5000
Fax Number	:	903-455-8232

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

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	04/30/2026

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Directions to “ DR. MOHAN P PHILIP M.D” Practice Location

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