Individual provider Active NPI

Tina J Philip, DO

  • Family Medicine Physician
  • Round Rock, TX
National Provider Identifier
1174793970
Registry record updated May 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N0367 Issued in TX
Practice address
511 Oakwood Blvd Ste 202
Round Rock, TX 78681-4068
Phone
(512) 388-0511
NPI assigned
Mar 7, 2008
Last updated
May 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X N0367 TX Primary

Addresses

Primary practice location

511 Oakwood Blvd Ste 202
Round Rock, TX 78681-4068

Mailing address

PO Box 4374
Houston, TX 77210-4374
Phone (512) 252-1505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090918000252 TX Practitioner - Family Practice 4587710439 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Texas HSC, College of Osteopathic Med, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

511 Oakwood Blvd
Suite 202
Round Rock, TX 78681-4068
Phone (512) 388-0511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
N0367TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Health Medical Group Family Medicine CurrentSince Sep 1, 2022 Accepting new patients
Rodom Medical Consulting PA Family Medicine CurrentSince Apr 1, 2018 Accepting new patients
Tina J. Philip, D.O. PLLC Family Medicine CurrentSince Nov 18, 2019 Accepting new patients
Gwendolyn Miller, MD, P.a. Family Medicine PastSince Sep 1, 2009 Accepting new patients

Locations

505 W Louis Henna Blvd
Ste 100
Austin, TX 78728
Phone (512) 252-1505

3101 S Austin Ave
Georgetown, TX 78626
Phone (512) 819-1100

1120 Cypress Station Dr
Houston, TX 77090
Phone (281) 893-7200

511 Oakwood Blvd
Ste 202
Round Rock, TX 78681
Phone (512) 388-0511

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/28292/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/EEIJBD/Endpoint/EEIJBD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588723200000",
    "number": "1174793970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4374",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772104374",
            "telephone_number": "512-252-1505",
            "fax_number": "512-252-1506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 OAKWOOD BLVD STE 202",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786814068",
            "telephone_number": "512-388-0511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILIP",
        "first_name": "TINA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-07",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N0367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.