Phillips, Gerald D

Phillips, Gerald D is an sole proprietor health care provider with primary practice located at 3030 E 29Th St Suite 106, Bryan TX 77802-2757. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Phillips, Gerald D can be contacted via phone (979) 731-8446.

Contact Information

Primary practice address
3030 E 29Th St Suite 106 Bryan TX 77802-2757
Phone: (979) 731-8446
Fax: (979) 731-8275
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 02145T Texas

Profile Details

NPI number 1063428407
LBN Legal business name Phillips, Gerald D
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 31st, 2006
Last updated Sep 2nd, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063428407 NPPES
Texas Other 16110 SPECTERA
Texas Other 80323E SPECTERA
Texas Other 3750 SPECTERA
Texas Other 54812 SPECTERA
Texas Other 6271 SPECTERA
Texas Other TX2145 SPECTERA
Texas Other 16258 SPECTERA
Texas MEDICAID 112311903 SPECTERA
Texas Other 59496 SPECTERA

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