Provider Demographics
NPI:1023568789
Name:PHILLIPS, DANIEL M III (PHD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:M
Last Name:PHILLIPS
Suffix:III
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22762 WESTHEIMER PKWY
Mailing Address - Street 2:SUITE 570
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-8825
Mailing Address - Country:US
Mailing Address - Phone:877-205-3267
Mailing Address - Fax:281-617-4936
Practice Address - Street 1:22762 WESTHEIMER PKWY
Practice Address - Street 2:SUITE 570
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-8825
Practice Address - Country:US
Practice Address - Phone:877-205-3267
Practice Address - Fax:281-617-4936
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-06
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32977103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist