Provider Demographics
NPI:1215373618
Name:APPLEGATE, PHILLIP DAVID JR
Entity Type:Individual
Prefix:
First Name:PHILLIP
Middle Name:DAVID
Last Name:APPLEGATE
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24022 CINCO VILLAGE CENTER BLVD
Mailing Address - Street 2:STE 240
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-3393
Mailing Address - Country:US
Mailing Address - Phone:832-376-8600
Mailing Address - Fax:832-376-8686
Practice Address - Street 1:24022 CINCO VILLAGE CENTER BLVD
Practice Address - Street 2:STE 240
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-3393
Practice Address - Country:US
Practice Address - Phone:832-376-8600
Practice Address - Fax:832-376-8686
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-13
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2188213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery