Phillip Church, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

E4257 Issued in TX

Practice address

1010 W 40TH St
Austin, TX 78756-4010

Phone

(512) 459-8753

Fax

(512) 483-6807

NPI assigned

Aug 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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

• Ascension Seton

  • Medicare Defined Swing Bed Hospital Unit
  • Smithville, TX
  • NPI 1598590101
  NPD (past)

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1386651206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 W 40TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787564010",
            "telephone_number": "512-459-8753",
            "fax_number": "512-483-6807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 W 40TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787564010",
            "telephone_number": "512-459-8753",
            "fax_number": "512-483-6807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TX",
            "license": "E4257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "824099",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tien Chung
• Travis Chung
• Yoon S. Chung, DDS
• Li-Yun Chuo, M.D.
• Chloe Church, RD
• Katherine L. Churchill, MSN, APRN, PMHNP-BC
• Shannon Churchill, PHARMD
• Desiree' Churchman
• Joanna Y. Chyu, MD
• Grace Kucera Ciamaricone, DPT

• Vascular Surgery Physician in Austin, TX
• Providers in Austin, TX by specialty
• Vascular Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.