MEDICARE: DR. PAUL M PHILLIPS 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	2086S0122X	Plastic and Reconstructive Surgery Physician	MD2016-0477	NM
2	2086S0122X	Plastic and Reconstructive Surgery Physician	R5453	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	:	1134381965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL M PHILLIPS M.D.

Provider Business Mailing Address
First Line	:	19310 STONE OAK PKWY
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-3248
Country	:	US
Telephone Number	:	210-270-8595
Fax Number	:

Provider Business Practice Location Address
First Line	:	19310 STONE OAK PKWY
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-3248
Country	:	US
Telephone Number	:	210-270-8595
Fax Number	:

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

Provider Enumeration Date	:	07/02/2008
Last Update Date	:	10/14/2024

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Directions to “ DR. PAUL M PHILLIPS M.D.” Practice Location

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