Phillip Dwight Cosby, PHYSICIAN ASSISTANT

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

12501 Judson Rd
Suite 102
Live Oak, TX 78233-4103

Phone

(210) 656-5100

NPI assigned

Oct 26, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• San Antonio Wound Care LLC

  • Clinic/Center
  • Live Oak, TX
  • NPI 1619502929
  NPD (past)

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912997347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 TREE BR",
            "city": "SCHERTZ",
            "state": "TX",
            "postal_code": "781542646",
            "telephone_number": "210-566-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12501 JUDSON RD",
            "address_2": "SUITE 102",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782334103",
            "telephone_number": "210-656-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSBY",
        "first_name": "PHILLIP",
        "middle_name": "DWIGHT",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah R Cook, P.T.
• Carnell Cooper, M.D.
• Mathilde Athenais Leontine Coquillaud-Salomon
• Sasha Cora, DC
• Yuni Corwin, APRN-CNP
• Council Oaks Community Options
• Council Oaks Community Options LTD
• Council Oaks Community Options LTD
• Council Oaks Community Options LTD
• Council Oaks Community Options LTD

• Medical Physician Assistant in Live Oak, TX
• Providers in Live Oak, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.