Individual provider Active NPI

Cynthia B Phillips, DO

  • Obstetrics & Gynecology Physician
  • Webster, TX
National Provider Identifier
1104885953
Registry record updated Jan 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
L0510 Issued in TX
Practice address
450 Medical Center Blvd
Suite 540
Webster, TX 77598-4234
Phone
(832) 932-5138
Fax
(832) 932-5142
NPI assigned
Mar 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X L0510 TX Primary

Addresses

Primary practice location

450 Medical Center Blvd
Suite 540
Webster, TX 77598-4234

Mailing address

PO Box 269092
Oklahoma City, OK 73126-9092
Phone (832) 932-5138

Other identifiers 2

IdentifierTypeStateIssuer
8V1890OtherTXBCBS INDIV PROVIDER #
179225101MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
L0510TXMDObstetrics & Gynecology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295913600000",
    "number": "1104885953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 269092",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731269092",
            "telephone_number": "832-932-5138",
            "fax_number": "832-932-5142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 MEDICAL CENTER BLVD",
            "address_2": "SUITE 540",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984234",
            "telephone_number": "832-932-5138",
            "fax_number": "832-932-5142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "CYNTHIA",
        "middle_name": "B",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-21",
        "last_updated": "2011-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "L0510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIV PROVIDER #",
            "identifier": "8V1890",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179225101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.