Phillips, Paul

Phillips, Paul is an sole proprietor health care provider with primary practice located at 104 Jordan Plaza Blvd Ste 402-403 , Tyler TX 75704-2055. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Phillips, Paul can be contacted via phone (903) 581-9472.

Contact Information

Primary practice address
104 Jordan Plaza Blvd Ste 402-403 Tyler TX 75704-2055
Phone: (903) 581-9472
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 11128 Texas

Profile Details

NPI number 1306293881
LBN Legal business name Phillips, Paul
Credentials LCDC
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 16th, 2016
Last updated May 16th, 2016 - about 9 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 1306293881 NPPES
Texas Other 11128 TEXAS STATE LICENSE LCDC

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