Theresa S. Phillips, MD, PA

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

J8714 Issued in TX

Legal business name

THERESA S. PHILLIPS, MD, PA

Practice address

710 Water St
#602
Kerrville, TX 78028-5329

Phone

(830) 257-1785

Fax

(830) 257-1786

NPI assigned

Apr 6, 2006

Organization subpart

No

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

Authorized official

Name

Theresa S Phillips, MD

Title

Owner

Phone

(830) 257-1785

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215648000000",
    "number": "1821050568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 293279",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780293279",
            "telephone_number": "830-257-1785",
            "fax_number": "830-257-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 WATER ST",
            "address_2": "#602",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780285329",
            "telephone_number": "830-257-1785",
            "fax_number": "830-257-1786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERESA S. PHILLIPS, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-06",
        "last_updated": "2008-07-10",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "830-257-1785",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "J8714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113481903",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.