Coppell Clinic, P.a.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

J0197 Issued in TX

Legal business name

COPPELL CLINIC, P.A.

Practice address

171 N Denton Tap Rd
Suite 200
Coppell, TX 75019-2915

Phone

(972) 745-4446

Fax

(972) 745-2597

NPI assigned

Nov 2, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Russell Wayne Phillips, D.O.

Title

Physician

Phone

(972) 745-4446

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1257120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257120000000",
    "number": "1346576949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 N DENTON TAP RD",
            "address_2": "SUITE 200",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750192915",
            "telephone_number": "972-745-4446",
            "fax_number": "972-745-2597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 N DENTON TAP RD",
            "address_2": "SUITE 200",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750192915",
            "telephone_number": "972-745-4446",
            "fax_number": "972-745-2597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPPELL CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-02",
        "last_updated": "2009-11-02",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "972-745-4446",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J0197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nolan Richard Coon, PT, DPT
• Bailey Marie Cooper
• Coppell Adult Medicine Specialist
• Coppell Associates in Family Medicine PA
• Coppell Care
• Coppell Emergency Physician Group PLLC
• Coppell ER LLC
• Coppell ER Physicians PLLC
• Coppell Ercare Facility, L.P.
• Coppell Family Medical Center, P.a.

• Family Medicine Physician in Coppell, TX
• Providers in Coppell, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2009; 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.